Two nosocomial pertussis outbreaks and their associated costs - King County, Washington, 2004.
OBJECTIVE
Pertussis outbreaks in healthcare settings result in resource-intensive control activities, but studies have rarely evaluated the associated costs. We describe and estimate costs associated with 2 nosocomial pertussis outbreaks in King County, Washington, during the period from July 25 to September 15, 2004. One outbreak occurred at a 500-bed tertiary care hospital (hospital A), and the other occurred at a 250-bed pediatric hospital (hospital B).


METHODS
We estimated the costs of each outbreak from the hospitals' perspective through standardized interviews with hospital staff and review of contact tracing logs. Direct costs included personnel time and laboratory and medication costs, whereas indirect costs were those resulting from hospital staff furloughs.


RESULTS
Hospital A incurred direct costs of $195,342 and indirect costs of $68,015; hospital B incurred direct costs of $71,130 and indirect costs of $50,000. Cost differences resulted primarily from higher personnel costs at hospital A ($134,536), compared with hospital B ($21,645). Total cost per pertussis case was $43,893 for hospital A (6 cases) and $30,282 for hospital B (4 cases). Total cost per person exposed to a pertussis patient were $357 for hospital A (738 exposures) and $164 for hospital B (737 exposures).


CONCLUSIONS
Nosocomial pertussis outbreaks result in substantial costs to hospitals, even when the number of pertussis cases is low. The cost-effectiveness of strategies to prevent nosocomial pertussis outbreaks, including vaccination of healthcare workers, should be evaluated.
Baggett
Henry C
HC
Communicable Diseases, Epidemiology, and Immunization Section, Public Health, Seattle and King County, WA, USA. hbaggett@cdc.gov.
Duchin
Jeffrey S
JS
Shelton
William
W
Zerr
Danielle M
DM
Heath
Joan
J
Ortega-Sanchez
Ismael R
IR
Tiwari
Tejpratap
T
D000328:Adult; D001886:Bordetella pertussis / Q000302:isolation & purification; D016358:Contact Tracing; D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000191:economics* / Q000517:prevention & control; D005260:Female; D006282:Health Personnel; D017721:Hospital Costs; D006769:Hospitals, General / Q000191:economics; D006776:Hospitals, Pediatric / Q000191:economics; D006801:Humans; D017053:Infection Control / Q000191:economics* / Q000379:methods; D007407:Interviews as Topic; D019982:Organizational Case Studies; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D014861:Washington / Q000453:epidemiology; D014917:Whooping Cough / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control