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


METHODS
Retrospective study.


METHODS
Academic tertiary care medical center and affiliated ambulatory care settings.


METHODS
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.


METHODS
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.
Zivna
Iva
I
Division of Infectious Diseases and Immunology, University of Massachusetts Memorial Medical Center, Worcester, MA 01655, USA. zivnai@ummhc.org
Bergin
Diana
D
Casavant
Joanne
J
Fontecchio
Sally
S
Nelson
Susan
S
Kelley
Anita
A
Mathis
Sandra
S
Melvin
Zita
Z
Erlichman
Rosemarie
R
Ellison
Richard T
RT
D000046:Academic Medical Centers / Q000191:economics*; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D001886:Bordetella pertussis / Q000302:isolation & purification; D016358:Contact Tracing / Q000191:economics*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000191:economics / Q000517:prevention & control*; D019983:Guideline Adherence; D017721:Hospital Costs; D006801:Humans; D017053:Infection Control / Q000191:economics* / Q000458:organization & administration; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000191:economics / Q000706:statistics & numerical data*; D008404:Massachusetts / Q000453:epidemiology; D010356:Patient Isolation; D010564:Personnel, Hospital; D010567:Pertussis Vaccine; D012189:Retrospective Studies; D014917:Whooping Cough / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D010567:Pertussis Vaccine