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Impact of Bordetella pertussis Exposures on a Massachusetts Tertiary Care Medical System

Published online by Cambridge University Press:  02 January 2015

Iva Zivna ,
Diana Bergin ,
Joanne Casavant ,
Sally Fontecchio ,
Susan Nelson ,
Anita Kelley ,
Sandra Mathis ,
Zita Melvin ,
Rosemarie Erlichman  and
Richard T. Ellison
Iva Zivna*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Massachusetts Medical School, Worcester
Diana Bergin
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Joanne Casavant
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Sally Fontecchio
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Susan Nelson
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Anita Kelley
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Sandra Mathis
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Zita Melvin
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Rosemarie Erlichman
Affiliation:
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
Richard T. Ellison
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of Massachusetts Medical School, Worcester Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester
*
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, 55 Lake Ave. N., Worcester, MA 01655 (zivnai@ummhc.org)
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Abstract

Objective.

To assess the impact of outbreaks of Bordetella pertussis infection on a tertiary care medical system.

Design.

Retrospective study.

Setting.

Academic tertiary care medical center and affiliated ambulatory care settings.

Subjects.

All patients and healthcare workers (HCWs) who were in close contact with patients with laboratory-confirmed cases of B. pertussis infection from October 1, 2003, through September 30, 2004.

Intervention.

Direct and indirect medical center costs were determined, including low and high estimates of time expended in the evaluation and management of exposed patients and HCWs during outbreak investigations of laboratory-confirmed cases of B. pertussis infection.

Results.

During this period, 20 primary and 3 secondary laboratory-confirmed cases of B. pertussis infection occurred, with 2 primary pertussis cases and 1 secondary case occurring in HCWs. Outbreak investigations prompted screening of 353 medical center employees. Probable or definitive exposure was identified for 296 HCWs, and 287 subsequently received treatment or prophylaxis for B. pertussis infection. Direct medical center costs for treatment and prophylaxis were $13,416 and costs for personnel time were $19,500-$31,190. Indirect medical center costs for time lost from work were $51,300-$52,300. The total cost of these investigations was estimated to be $85,066-$98,456.

Conclusions.

Frequent B. pertussis exposures had a major impact on our facility. Given the impact of exposures on healthcare institutions, routine vaccination for HCWs may be beneficial.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 6 , June 2007 , pp. 708 - 712
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1.Tanaka, M, Vitek, CR, Pascual, FB, Bisgard, KM, Tate, JE, Murphy, TV. Trends in pertussis among infants in the United States, 1980-1999. JAMA 2003;290:2968–2975.Google Scholar
2.Christie, C, Marx, M, Merchant, C, Reising, SF. The 1993 epidemic of pertussis in Cincinnati: resurgence of disease in a highly immunized population of children. N Engl J Med 1994;331:16–21.CrossRefGoogle Scholar
3.Senzilet, LD, Halperin, SA, Spika, JS, Alagaratnem, M, Morris, A, Smith, B; Sentinel Health Unit Surveillance System Pertussis Working Group. Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clin Infect Dis 2001;32:1691–1697.CrossRefGoogle ScholarPubMed
4.Birkebaek, NH, Kirstiansen, M, Seefeldt, T, et al.Bordetella pertussis and chronic cough in adults. Clin Infect Dis 1999;29:1239–1242.CrossRefGoogle ScholarPubMed
5.He, Q, Viljanen, MK, Arvilomni, H, Aittanen, B, Mertsola, J. Whooping cough caused by Bordetella pertussis and Bordetella parapertussis in an immunized population. JAMA 1998;280:635–637.Google Scholar
6.Nennig, ME, Shinefield, HR, Edwards, KM, Black, SB, Fireman, BH. Prevalence and incidence of adult pertussis in an urban population. JAMA 1996;275:1672–1674.Google Scholar
7.Wright, SW, Edwards, KM, Decker, MD, Zeldin, MH. Pertussis infection in adults with persistent cough. JAMA 1995;273:1044–1046.Google Scholar
8.Yih, WK, Lett, SM, des Vignes, FN, Garrison, KM, Sipe, PL, Marchant, CD. The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989-1998. J Infect Dis 2000;182:1409–1416.CrossRefGoogle ScholarPubMed
9.Strebel, P, Nordin, JD, Edwards, K, et al.Population-based incidence of pertussis among adolescents and adults, Minnesota, 1995-1996. J Infect Dis 2001;183:1353–1359.Google Scholar
10.Vitek, CR, Pascual, FB, Baughman, AL, Murphy, TV. Increase in deaths from pertussis among young infants in the United States in the 1990s. Pediatr Infect Dis J 2003;22:628–634.Google Scholar
11.Schellekens, J, Wirsing von Konig, CH, Gardner, P. Pertussis sources of infection and routes of transmission in the vaccination era. Pediatr Infect Dis J 2005;24(5 suppl): S19–S24.CrossRefGoogle ScholarPubMed
12.Wirsing von König, CH, Postels-Multani, S, Bock, HL, Schmitt, HJ. Pertussis in adults: frequency of transmission after household exposure. Lancet 1995;346:1326–1329.Google Scholar
13.Steketee, RW, Wassilak, SG, Adkins, WN Jr, et al.Evidence for a high attack rate and efficacy of erythromycin prophylaxis in a pertussis outbreak in a facility for the developmentally disabled. J Infect Dis 1988;157:434–440.Google Scholar
14.Bassinet, L, Matrat, M, Njakempo, E, Aberrane, S, Housset, B, Guiso, N. Nosocomial pertussis outbreak among adult patients and healthcare workers. Infect Control Hosp Epidemiol 2004;25:995–997.Google Scholar
15.Ward, A, Caro, J, Bassinet, L, Housset, B, O'Brien, JA, Guiso, N. Health and economic consequences of an outbreak of pertussis among healthcare workers in a hospital in France. Infect Control Hosp Epidemiol 2005;26:288–292.Google Scholar
16.Boulay, BR, Murray, CJ, Ptak, J, Kirkland, KB, Montero, J, Talbot, EA. An outbreak of pertussis in a hematology-oncology care unit: implications for adult vaccination policy. Infect Control Hosp Epidemiol 2006;27:92–95.Google Scholar
17.Fisher, MC, Long, SS, McGowan, KL, Kaselis, E, Smith, DG. Outbreak of pertussis in a residential facility for handicapped people. J Pediatr 1989;114:934–939.CrossRefGoogle Scholar
18.Addiss, DG, Davis, JP, Meade, BD, et al.A pertussis outbreak in a Wisconsin nursing home. J Infect Dis 1991;164:704–710.Google Scholar
19.Massachusetts Department of Public Health, Division of Epidemiology and Immunization. Guide to Surveillance, Reporting and Control. Boston: Massachusetts Department of Public Health; January 2001. 2006 edition available at: http://www.mass.gov/dph/cdc/gsrman. Accessed May 2, 2007.Google Scholar
20.Pertussis—United States, 1997-2000. MMWR Morb Mortal Wkly Rep 2002;51:73–76.Google Scholar
21.National Immunization Program. Guidelines for the control of pertussis outbreaks. Atlanta, GA: Centers for Disease Control; 2000 (Amendments made in 2005 and 2006). Available at: http://www.cdc.gov/nip/publications/pertussis/guide.htm. Accessed May 2, 2007.Google Scholar
22.Kretsinger, K, Broder, KR, Cortese, MM, et al.; Centers for Disease Control and Prevention; Advisory Committee on Immunization Practices; Healthcare Infection Control Practices Advisory Committee. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of the ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC) for the use of Tdap among health-care personnel. MMWR Morb Mortal Wkly Rep 2006;55(RR-17): 1–37.Google Scholar