A NATIONWIDE PROSPECTIVE SURVEILLANCE STUDY IN ISRAEL TO DOCUMENT PEDIATRIC INVASIVE INFECTIONS, WITH AN EMPHASIS ON HAEMOPHILUS-INFLUENZAETYPE-B INFECTIONS

Background and methods. An ongoing nationwide prospective surveillance study was initiated in Israel in October, 1988, to document childhood invasive infections caused by Haemophilus influenzae type b (Hib), St reptococcus pneumoniae and Neisseria meningitidis. This study enabled us to document the effect on childhood invasive Hib disease of the int roduction of conjugate Hib vaccines to Israel. Results, The incidence of invasive Hib disease before the age of 5 years dropped from 34 per 100 000 before initiation of immunization to < 5 per 100 000 in 1995 a nd is projected to be <4 in 1996, After <2 years, when various conjuga te vaccines had been available in the private sector alone and had ach ieved partial coverage only, the Israeli Ministry of Health decided to add Hib conjugate vaccine to the regular infant immunization program, free of charge, effective for all infants born after January 1, 1994. The vaccine chosen was Nib polysaccharide linked to outer membrane pr otein complex of N. meningitidis B. Vaccine coverage has exceeded 90% of all infants born since January 1, 1994, Efficacy and effectiveness during the first 34 months of the program (January 1, 1994, to October 31, 1996) were 95.4 and 99.7%, respectively, for all invasive Hib dis ease and 97 and 99.4%, respectively, for Nib meningitis. Conclusion. T he described ongoing surveillance program showed the existence and ext ent of Hib problems in Israel and documented the success of the immuni zation program in essentially eliminating the disease in Israel.