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- Title
Haemophilus influenzae Serotype a (Hia) Carriage in a Small Alaska Community After a Cluster of Invasive Hia Disease, 2018.
- Authors
Nolen, Leisha D; Tiffany, Amanda; DeByle, Carolynn; Bruden, Dana; Thompson, Gail; Reasonover, Alisa; Hurlburt, Debby; Mosites, Emily; Simons, Brenna C; Klejka, Joe; Castrodale, Louisa; McLaughlin, Joseph; Bruce, Michael G
- Abstract
Background Between May and July 2018, 4 Haemophilus influenzae serotype a (Hia) infections occurred in a remote Alaska community. We performed a public health response to prevent further illness and understand Hia carriage. Methods We collected oropharyngeal samples community-wide to evaluate baseline carriage. Risk factors were evaluated by interview. We offered prophylactic rifampin to individuals in contact with invasive Hia patients (contacts) and to all children aged <10 years. Oropharyngeal samples were collected again 8 weeks after rifampin distribution. Samples were tested using real-time polymerase chain reaction and culture. Results At baseline, 4 of 27 (14.8%) contacts and 7 of 364 (1.9%) noncontacts (P <.01) carried Hia. Contacts aged <10 years were more likely to carry Hia at any timepoint (11/18 [61%]) compared to contacts aged ≥10 years (3/34 [8.8%]), noncontacts aged <10 years (2/139 [1.4%]), and noncontacts ≥10 years (6/276 [2.2%]) (P <.001 for all). Hia carriers were clustered in 9 households (7% of total households). At the household level, carriage was associated with households with ≥1 contact (prevalence ratio [PR], 5.6 [95% confidence interval {CI}, 1.3–21.6]), crowding (PR, 7.7 [95% CI, 1.1–199.5]), and ≥3 tobacco users (PR, 5.0 [95% CI, 1.2–19.6]). Elevated carriage prevalence persisted in contacts compared to noncontacts 8 weeks after rifampin distribution (6/25 [24%] contacts, 2/114 [1.8%] noncontacts; P <.001). Conclusions Hia carriage prevalence was significantly higher among contacts than noncontacts. Rifampin prophylaxis did not result in a reduction of Hia carriage prevalence in this community.
- Subjects
ALASKA; DNA analysis; SECRETION; CONFIDENCE intervals; RURAL conditions; HAEMOPHILUS diseases; FISHER exact test; HAEMOPHILUS influenzae; RISK assessment; CHI-squared test; DESCRIPTIVE statistics; CARRIER state (Communicable diseases); RIFAMPIN; POLYMERASE chain reaction; CONTACT tracing; DATA analysis software; OROPHARYNX; DISEASE risk factors
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 2, pe280
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa750