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Continuing surveillance of invasive Haemophilus influenzae disease in northwestern Ontario emphasizes the importance of serotype a and non-typeable strains as causes of serious disease: a Canadian Immunization Research Network (CIRN) Study.

Authors
  • Cerqueira, Ashley1
  • Byce, Sarah2
  • Tsang, Raymond S W3
  • Jamieson, Frances B4, 5
  • Kus, Julianne V4, 5
  • Ulanova, Marina6
  • 1 Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. , (Canada)
  • 2 Faculty of Medicine, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. , (Canada)
  • 3 Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada. , (Canada)
  • 4 Public Health Laboratories, Public Health Ontario, Toronto, Ontario, Canada. , (Canada)
  • 5 Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. , (Canada)
  • 6 Division of Medical Sciences, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. , (Canada)
Type
Published Article
Journal
Canadian Journal of Microbiology
Publisher
Canadian Science Publishing
Publication Date
Nov 01, 2019
Volume
65
Issue
11
Pages
805–813
Identifiers
DOI: 10.1139/cjm-2019-0210
PMID: 31242396
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In the post-Haemophilus influenzae serotype b (Hib) vaccine era, invasive H. influenzae serotype a (Hia) disease emerged in Canadian First Nation, Inuit, and Alaskan Indigenous populations. Previous studies by our group found a high incidence of invasive Hia disease in northwestern Ontario. We retrospectively reviewed 24 cases (4 pediatric and 20 adult) of invasive H. influenzae disease hospitalized at the northwestern Ontario regional hospital between August 2011 and June 2018. The objectives were to further document the changing epidemiology of invasive H. influenzae disease in the region and to discuss potential control measures. Twenty-two H. influenzae isolates were serotyped and characterized using molecular-biological methods. Of the serotyped cases, there were 2 Hib, 9 Hia, and 11 non-typeable (NTHi). All Hia isolates belonged to the most common sequence types (ST) found in Canada (ST-23 and ST-929); 8 out of 9 were pan susceptible to antibiotics. One (11%) of 9 Hia and 5 (45%) of 11 NTHi cases were fatal. Our data on the consistent presence of serious invasive H. influenzae disease, with 41% prevalence of Hia (9 out of 22 serotyped isolates) and 50% prevalence of NTHi strains (11 out of 22), emphasize the importance of continued surveillance of H. influenzae in the post-Hib vaccine era and are critical information to inform potential vaccine development.

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