In May 2023, the Detroit Health Department was notified of four cases of invasive nontypeable Haemophilus influenzae (Hi) disease among students attending the same elementary school and grade, all with illness onsets within 7 days. Three patients were hospitalized, and one died. Most U.S. cases of invasive Hi disease are caused by nontypeable strains. No vaccines against nontypeable or non-type b Hi strains are currently available. Chemoprophylaxis is not typically recommended in response to nontypeable Hi cases; however, because of the high attack rate (four cases among 46 students; 8.7%), rifampin prophylaxis was recommended for household contacts of patients with confirmed cases and for all students and staff members in the school wing where confirmed cases occurred. Only 10.8% of students for whom chemoprophylaxis was recommended took it, highlighting gaps in understanding among caregivers and health care providers about persons for whom chemoprophylaxis was recommended. Public health authorities subsequently enhanced communication and education to the school community, improved coordination with health care partners, and established mass prophylaxis clinics at the school. This outbreak highlights the potential for nontypeable Hi to cause serious illness and outbreaks and the need for chemoprophylaxis guidance for nontypeable Hi disease. Achieving high chemoprophylaxis coverage requires education, communication, and coordination with community and health care partners.

中文翻译：

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2023 年 5 月，密歇根州一所小学爆发侵袭性不可分型流感嗜血杆菌疾病。


2023 年 5 月，底特律卫生部门接到通知，同一小学和年级的学生中出现了 4 例侵袭性不可分型流感嗜血杆菌 (Hi) 病例，所有病例均在 7 天内发病。三名患者入院治疗，其中一名死亡。美国大多数侵袭性 Hi 病病例是由不可分型菌株引起的。目前还没有针对不可分型或非 b 型 Hi 病毒株的疫苗。对于无法分型的 Hi 病例，通常不建议进行化学预防；然而，由于发病率较高（46 名学生中有 4 例；8.7%），建议对确诊病例患者的家庭接触者以及发生确诊病例的学校的所有学生和工作人员使用利福平进行预防。在建议进行化学预防的学生中，只有 10.8% 接受了该药物，这突显了护理人员和医疗保健提供者对建议进行化学预防的人的理解存在差距。公共卫生当局随后加强了与学校社区的沟通和教育，改善了与医疗保健合作伙伴的协调，并在学校建立了大规模预防诊所。此次疫情凸显了不可分型 Hi 疾病导致严重疾病和疫情爆发的可能性，以及对不可分型 Hi 疾病进行化学预防指导的必要性。实现高化学预防覆盖率需要与社区和医疗保健合作伙伴进行教育、沟通和协调。