STUDY ON HAEMOPHILUS-INFLUENZAE TYPE-B DISEASES IN CHINA - THE PAST, PRESENT AND FUTURE

Meningitis caused by Haemophilus influenzae type b (Hib) is a common a nd serious disease for which there now are WHO-certified vaccines that are recommended for universal infant immunization in North America an d European countries. If these vaccines are to be recommended in Asia, it is necessary to know the incidence, age distribution and clinical outcome of Hib meningitis and other systemic infections in this region . Data on Hib disease in China are scanty. Hib meningitis was common d uring the 1950s in China, accounting for up to 16% of all of pyogenic meningitis (up to 38% of cases were caused by unknown pathogens), desp ite severe epidemics of meningococcal meningitis during that period. S ince 1989 we have conducted hospital- and community-based etiologic an d epidemiologic studies of bacterial meningitis. Hib accounts for 30 t o 50% of bacterial meningitis in China. The incidence of Hib meningiti s in Hefei City was 10.4 per 100 000 children <5 years, a result relat ively lower than in the West but higher than the rate of 2.7 found in a retrospective study in Hong Kong. Pneumonia is the primary cause of death for Chinese children. From 1991 to 1993 the average mortality of children <5 years because of pneumonia was 1563.2 per 100 000. To ach ieve the goal of reducing the death rate of children by one-third by t he year 2000, greater efforts should be made to reduce the mortality o f children with pneumonia. Our preliminary study showed that about one -fourth to one-third of cases of pneumonia in Chinese children might b e caused by Hib. Therefore Hib vaccination for infants and children in China might be an effective and valuable procedure to achieve the goa l.