title: A modified "cover your cough" campaign prevents exposures of employees to pertussis at a children's hospital.
abstract: BACKGROUND
  In the 4th quarter of 2004, there was an increase in patients seeking medical care for pertussis symptoms at the Children's Hospital, Omaha, NE. The Hospital Epidemiology service noted a sharp rise in exposures of Children's Hospital employees to these patients, requiring employee testing, prophylactic antibiotic prescriptions, and relief from duty.
  
  
  METHODS
  Initial efforts at employee education failed to prevent the exposures. An exposure-control plan was then initiated by placing "Cover Your Cough" posters (in English and Spanish) describing appropriate cough etiquette at entrances to the emergency room, outpatient clinics, and hospital lobby. In addition, personal protective equipment (PPE) including child- and adult-sized masks, hand sanitizers, and tissues were provided at these stations for patients and their attendants.
  
  
  RESULTS
  Prior to the initiation of the above exposure control measures, there were 166 reports of employee exposure to patients and other employees with pertussis symptoms during a 4-week period. Of these, 140 were given prophylactic antibiotics, and 31 underwent diagnostic testing for pertussis and required paid time off from work. The cost of antibiotics and diagnostic testing was $17,407.00. After the introduction of the modified "Cover Your Cough" campaign, the number of employee exposures declined significantly to 37 in the next 4-week period. Notably, the number of patients tested for pertussis during the second 4-week period was 290 compared to 162 in the first 4-week period, indicating continuation of the epidemic.
  
  
  CONCLUSIONS
  Availability of PPE along with posters regarding cough etiquette at entry points of the hospital interrupted employee exposure to patients/personnel with pertussis symptoms significantly, when an employee educational initiative alone was unable to achieve this outcome.
authors.affiliation: Department of Pediatrics, Creighton University Medical Center, Children's Hospital, Omaha, Nebraska, USA. achatter@creighton.edu
authors.forename: Archana
authors.initials: A
authors.lastname: Chatterjee
authors.forename: Sharon
authors.initials: S
authors.lastname: Plummer
authors.forename: Brenda
authors.initials: B
authors.lastname: Heybrock
authors.forename: Tami
authors.initials: T
authors.lastname: Bardon
authors.forename: Kay
authors.initials: K
authors.lastname: Eischen
authors.forename: Mel
authors.initials: M
authors.lastname: Hall
authors.forename: Steven
authors.initials: S
authors.lastname: Lazoritz
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003371:Cough; D006776:Hospitals, Pediatric; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional; D009784:Occupational Diseases / Q000517:prevention & control; D016273:Occupational Exposure / Q000517:prevention & control*; D010564:Personnel, Hospital / Q000193:education*; D014917:Whooping Cough / Q000517:prevention & control* / Q000635:transmission