Surveillance of Haemophilus influenzae infection

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7286.613/b (Published 10 March 2001) Cite this as: BMJ 2001;322:613

Surveillance data for assessing impact of vaccination are valid

  1. Mary Ramsay (mramsay@phls.org.uk), consultant epidemiologist,
  2. Mary Slack, consultant microbiologist,
  3. Edward Kaczmarski, consultant microbiologist
  1. PHLS Communicable Disease Surveillance Centre, London NW9 5EQ
  2. PHLS Haemophilus Reference Unit, John Radcliffe Hospital, Oxford OX3 9DU
  3. PHLS Meningococcal Reference Unit, Withington Hospital, Manchester M20 2LR
  4. Section of Child Health, School of Postgraduate Medicine, University of Warwick, Coventry CV4 7AL
  5. Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT

    EDITOR—Olowokure et al suggest that routine surveillance of Haemophilus influenzae is incomplete, that completeness declined after the vaccine was introduced, and that the effectiveness of vaccination programmes is overestimated.1 We question this.

    The authors suggest that the same weakness may affect the surveillance of the group C meningococcal vaccination programme. We accept that routine reporting is often incomplete, but, because of this, all vaccine preventable infections are under enhanced surveillance. The 15-fold reduction in the incidence of H influenzae type b disease after the introduction of the H influenzae type b vaccine was observed in an enhanced active surveillance scheme operating in five NHS regions,2 not by the use of routine laboratory reports to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre.

    This surveillance scheme was established before the vaccine was introduced and …

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