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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*
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 ([email protected])

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
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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