Abstract：
BACKGROUND: Haemophilus influenzae (Hi) can cause severe disease in children. This study aimed to identify risk factors related to invasive Hi disease in Alaska children and evaluate carriage in people around them.
METHODS: From 2005 to 2011, we investigated episodes of invasive, typeable Hi disease in Alaska children <10 years old. Three age-matched control children were enrolled for each case-patient. We evaluated oropharyngeal Hi carriage in people in close contact with Hi case-patients (contacts) as well as control children and their household members. Individual and household risk factors for illness and carriage were evaluated using questionnaires and chart reviews.
RESULTS: Thirty-eight of 44 (86%) children with invasive, typeable Hi disease were recruited: 20 Hi serotype a (53%), 13 serotype b (Hib) (34%) and 5 serotype f (13%). Children with the invasive Hi disease were more likely than controls to have underlying health problems (67% vs. 24%, P = 0.001), other carriers of any Hi in their household (61% vs. 15%, P < 0.001), and inadequate Hib vaccination (26% vs. 9%, P = 0.005). People who carried Hi were younger than noncarriers (mean 12.7 vs. 18.0 years, P = 0.008). The carriage was clustered within case-patient households, with carriage in 19% of household contacts, while only 6.3% of nonhousehold contacts and 5.5% of noncontacts carried the Hi serotype of interest ( P < 0.001).
CONCLUSIONS: Factors associated with invasive Hi disease in children included underlying health problems, household carriage and inadequate Hib vaccination. The high level of carriage in case-patient households is important to consider when evaluating treatment and prophylaxis strategies.
METHODS: From 2005 to 2011, we investigated episodes of invasive, typeable Hi disease in Alaska children <10 years old. Three age-matched control children were enrolled for each case-patient. We evaluated oropharyngeal Hi carriage in people in close contact with Hi case-patients (contacts) as well as control children and their household members. Individual and household risk factors for illness and carriage were evaluated using questionnaires and chart reviews.
RESULTS: Thirty-eight of 44 (86%) children with invasive, typeable Hi disease were recruited: 20 Hi serotype a (53%), 13 serotype b (Hib) (34%) and 5 serotype f (13%). Children with the invasive Hi disease were more likely than controls to have underlying health problems (67% vs. 24%, P = 0.001), other carriers of any Hi in their household (61% vs. 15%, P < 0.001), and inadequate Hib vaccination (26% vs. 9%, P = 0.005). People who carried Hi were younger than noncarriers (mean 12.7 vs. 18.0 years, P = 0.008). The carriage was clustered within case-patient households, with carriage in 19% of household contacts, while only 6.3% of nonhousehold contacts and 5.5% of noncontacts carried the Hi serotype of interest ( P < 0.001).
CONCLUSIONS: Factors associated with invasive Hi disease in children included underlying health problems, household carriage and inadequate Hib vaccination. The high level of carriage in case-patient households is important to consider when evaluating treatment and prophylaxis strategies.
摘要：
背景：流感嗜血杆菌（Hi）可引起儿童严重疾病。这项研究旨在确定与阿拉斯加儿童侵袭性Hi疾病相关的危险因素，并评估周围人群的携带情况。
方法：从2005年到2011年，我们调查了侵入性，阿拉斯加年龄<10岁儿童的可分型Hi病。每个病例患者招募三名年龄匹配的对照儿童。我们评估了与Hi病例患者（接触者）密切接触的人以及控制儿童及其家庭成员的口咽Hi携带。使用问卷和图表评论评估了个人和家庭疾病和运输的危险因素。
结果：44例（86%）侵袭性儿童中有38例，招募了可分型的Hi病：20Hi血清型a（53％），13血清型b(Hib)(34%)和5血清型f(13%)。患有侵袭性Hi病的儿童比对照组更有可能出现潜在的健康问题(67%与24%,P=0.001),家庭中任何Hi的其他携带者(61%与15%,P<0.001)，和Hib疫苗接种不足(26%vs.9%,P=0.005)。携带Hi的人比非携带者年轻（平均12.7vs.18.0年,P=0.008)。马车聚集在病例患者家庭中，在19%的家庭联系人中有马车，而只有6.3％的非家庭接触者和5.5％的非接触者携带感兴趣的Hi血清型（P<0.001）。
结论：与儿童侵袭性Hi疾病相关的因素包括潜在的健康问题，家庭运输和Hib疫苗接种不足。在评估治疗和预防策略时，必须考虑病例患者家庭的高水平运输。
方法：从2005年到2011年，我们调查了侵入性，阿拉斯加年龄<10岁儿童的可分型Hi病。每个病例患者招募三名年龄匹配的对照儿童。我们评估了与Hi病例患者（接触者）密切接触的人以及控制儿童及其家庭成员的口咽Hi携带。使用问卷和图表评论评估了个人和家庭疾病和运输的危险因素。
结果：44例（86%）侵袭性儿童中有38例，招募了可分型的Hi病：20Hi血清型a（53％），13血清型b(Hib)(34%)和5血清型f(13%)。患有侵袭性Hi病的儿童比对照组更有可能出现潜在的健康问题(67%与24%,P=0.001),家庭中任何Hi的其他携带者(61%与15%,P<0.001)，和Hib疫苗接种不足(26%vs.9%,P=0.005)。携带Hi的人比非携带者年轻（平均12.7vs.18.0年,P=0.008)。马车聚集在病例患者家庭中，在19%的家庭联系人中有马车，而只有6.3％的非家庭接触者和5.5％的非接触者携带感兴趣的Hi血清型（P<0.001）。
结论：与儿童侵袭性Hi疾病相关的因素包括潜在的健康问题，家庭运输和Hib疫苗接种不足。在评估治疗和预防策略时，必须考虑病例患者家庭的高水平运输。
