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Dynamics of natural immunity caused by subclinical infections, case study on Haemophilus influenzae type b (Hib)

Published online by Cambridge University Press:  01 March 2001

T. LEINO
Affiliation:
National Public Health Institute, Mannerheimintie 166, FIN 00300 Helsinki, Finland
K. AURANEN
Affiliation:
Rolf Nevanlinna Institute, P.O. Box 4, FIN 00014 University of Helsinki, Finland
P. H. MÄKELÄ
Affiliation:
National Public Health Institute, Mannerheimintie 166, FIN 00300 Helsinki, Finland
H. KÄYHTY
Affiliation:
National Public Health Institute, Mannerheimintie 166, FIN 00300 Helsinki, Finland
A. K. TAKALA
Affiliation:
National Public Health Institute, Mannerheimintie 166, FIN 00300 Helsinki, Finland
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Abstract

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Natural immunity to Haemophilus influenzae type b (Hib) is based primarily on antibodies that are thought to develop in response to subclinical infections. Wide use of conjugated Hib vaccines could lead to decreases in circulating Hib bacteria, thereby diminishing antibody levels in the unvaccinated. We applied a statistical model to estimate the duration of natural immunity to Hib under different forces of infection. Prior to the introduction of conjugated Hib vaccines, new Hib infections were estimated to occur once in 4 years and the antibody concentration to stabilize at a level around 1 μg/ml. In the absence of new stimuli, i.e. infection, 57% of the unvaccinated population would become susceptible to invasive disease (antibody levels < 0·15 μg/ml) in 10 years. Due to an interaction between the force of infection and the duration of immunity, in some situations numbers of invasive infections could increase in unvaccinated cohorts. This theoretical scenario has yet to be observed in practice.

Type
Research Article
Copyright
2000 Cambridge University Press