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The use of vaccines against the bacterium Hemophilus influenzae type b (hib) has reduced the incidence of Hib disease in many military bases. Government data on hospitalization rates of children of military personnel show that the incidence of Hib disease in children under the age of five has dropped 50% since 1987. The first Hib vaccine was licensed in 1985, followed in 1987 by a conjugate vaccine that was more effective. In 1986, 188 cases of Hib disease were treated at military hospitals, compared to only 43 in 1991. An estimated two million doses of vaccine were purchased by the Department of Defense between 1985 and 1991, and in 1991, more than 80% of eligible children were vaccinated. The incidence of Hib meningitis began falling in 1988, two years before the vaccine was licensed in infants, who have the highest risk of the disease. This could reflect a drop in the number of carriers among the older children., Objective.--To document trends in the incidence of invasive Haemophilus influenzae diseases in young children of US Army active duty soldiers following the publication of H influenzae type b immunization recommendations for young children between 1985 and 1990. Design.--A population-based surveillance of hospital discharge diagnoses for H influenzae invasive diseases. Setting.--Military and civilian medical treatment facilities around the world. Patients.--There was a mean population of nearly 200000 US Army health care beneficiaries younger than 5 years of age each year of the study. Outcome Measures.--Annual total and age-specific incidences of the six most common H influenzae invasive diseases in this population (meningitis, epiglottitis, septicemia, pneumonia, cellulitis, and septic arthritis). Results.--The annual number of cases of H influenzae invasive diseases decreased from a high of 188 in 1986 to 43 in 1991. The incidence in the age group at highest risk for H influenzae disease, those 6 to 11 months of age, decreased from 355 per 100000 children in 1986 to 116 per 100000 in 1991 (P Conclusions.--The decrease in H influenzae invasive diseases closely follows the dates of H influenzae type b vaccine licensure for use in progressively younger age groups. Some age groups, however, experienced a decline in disease rates even before becoming eligible for vaccination. (JAMA. 1993;269:227-231)

Recently there has been resurgence in the number of cases of measles, mumps, and rubella (German measles). Many of these cases are occurring not in the young child, as in the past, but in teenagers and young adults. A study was undertaken to determine the level of immunity of young adults, in an effort to provide information to those who make national and military immunization policy decisions. There were 1,547 US army recruits included in the study; the recruits were given a questionnaire and blood samples were obtained. Blood samples were evaluated for antibody status (presence of antibodies indicates immunity) against measles, mumps, rubella, and varicella (chicken pox), as well as poliovirus types 1, 2, and 3. The results of the blood analysis revealed that 20.7 percent of recruits were without antibodies against measles; 15.6 percent, against mumps; 17.6 percent against rubella; and 6.9 percent against varicella. Susceptibility to measles, mumps, and rubella was less in women, blacks, and college-educated recruits; women and backs were more susceptible to varicella. Older recruits (those born before 1970) more often had immunity to measles, mumps and rubella than did younger recruits. A total of 2.3 percent of the recruits lacked immunity to polio type 1; 0.6 percent to type 2; and 14.6 percent to type 3. It is concluded that immunity to measles, mumps, and rubella is unevenly distributed among young Americans. These findings support the national objective of improving immunization in school children and young adults. Results support legislation which would require those entering college to present evidence of at least two measles vaccinations, one of which having been given at or after admission to elementary school. (Consumer Summary produced by Reliance Medical Information, Inc.)