Haemophilus
influenzae type b (Hib) infections have been documented in China previously.
However, the data are scanty and incomplete. Hib meningitis accounted for up to
16% of all pyogenic meningitis during the 1950s. In the 1900s, it accounted for
30-50% of bacterial meningitis in China. A study, supported by the World Health
Organization, on the epidemiologic information of bacterial meningitis in
infants and children with special emphasis on Hib in Beijing Children’s
Hospital (BCH) and Hefei City was completed in 1992. It has studied 128
patients clinically diagnosed to have bacterial meningitis in BCH from 1988 to
1989. Hib was diagnosed in 37 (29%) of the 128 cases and 84% was <2 years
old. Most of the cases occurred in winter and spring. Another study done in
Hefei City from 1990 to 1992, including 13 hospitals in Hefei City, found that
Hib was the most common cause of bacterial meningitis, accounting for 52% of
total cases. The incidence of Hib meningitis in Hefei City was 10.4 per 100,000
in children <5 years old. For pneumonia, the yield of culture has been
consistently low due mainly to the prior use of antibiotics. By detection of
antigens, two studies at BCH found evidence of Hib infection in about one
quarter of children with pneumonia.10 There was no report on other Hib diseases
like epiglottitis, sepsis available for China.
There were limited data about Streptococcus pneumoniae infections in
China. The first study on the epidemiology of S. pneumoniae was performed in collaboration with World Health
Organization during 1982-1985. It included 27 hospitals from 18 provinces, with
more than 400 cases of pneumococcal infections. The rates of pneumococcal
pneumonia, meninigitis and otits media were 14 cases, 79 cases and 68 cases per
1000 homologous disease cases respectively. Most of the cases were in children
less than or equal to 3 years old. The mortality rates for pneumococcal
pneumonia and meningitis were 16.4% and 16% respectively. Majority of them were
patients less than 1 year old or more than 50 years old. Overall, the six
commonest serotypes found in this study, in descending order, were 5, 6, 1, 19,
2 and 14. They accounted for 59% of all S.
pneumoniae identified in the study. In descending order of frequency, the
“pneumonia‑related” serotypes were 1, 5, 14, 6, 21 and 28 while the “meningitis‑related”
serotypes were serotypes 2, 5, 6, 1, 27 and 14. Compared to overseas data, the
incidence of type 5 pneumococcal infections in China was higher. Another study
on acute bacterial meningitis in children was conducted in Hefei from 1990 to
1992. Of all the bacterial meningitis in children between the age of 1 month to
5 years old, 8.3% were caused by S.
pneumoniae. The case fatality rate was up to 20%. Meanwhile, the data is
still incomplete and further studies are now actively undergoing in China.