title: Healthcare-Associated Pertussis Outbreak in Arizona: Challenges and Economic Impact, 2011.
abstract: An outbreak investigation identified 15 pertussis cases among 5 infants and 10 healthcare professionals at 1 hospital's neonatal intensive care unit (NICU). The cost of the outbreak to this hospital was $97 745. Heightened awareness of pertussis in NICUs is key to preventing healthcare-associated spread and minimizing outbreak-control-related costs. Bordetella pertussis is a highly communicable bacterial pathogen that causes a prolonged cough illness and is spread by respiratory droplet transmission. Infants aged ≤6 months are most susceptible to B pertussis infection and pertussis-associated complications, including pneumonia, encephalopathy, and death, and are commonly hospitalized for treatment [ 1]. Despite a universal pertussis vaccination program, 27 550 pertussis cases were reported in the United States during 2010 [ 2]. Pertussis outbreaks in healthcare settings can be challenging and costly to control [3]. On September 13, 2011 and September 15, 2011, 3 pertussis cases, including 2 confirmed by B pertussis isolation, among preterm infants discharged ≤30 days previously from a 71-bed NICU of a general hospital (NICU A) were reported by Hospital B, a large pediatric facility, to Maricopa County Department of Public Health. This report describes the outbreak, examines outbreak-associated costs and risk factors that might have contributed to healthcare-associated transmission, and provides guidance to prevent outbreaks in healthcare settings.
authors.affiliation: Epidemic Intelligence Service syasmin@cdc.gov.
authors.forename: Seema
authors.initials: S
authors.lastname: Yasmin
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sunenshine
authors.affiliation: Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Bisgard
authors.affiliation: Arizona Department of Health Services.
authors.forename: Caleb
authors.initials: C
authors.lastname: Wiedeman
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Alice
authors.initials: A
authors.lastname: Carrigan
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Tammy
authors.initials: T
authors.lastname: Sylvester
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Greg
authors.initials: G
authors.lastname: Garcia
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Karen
authors.initials: K
authors.lastname: Rose
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Sun
authors.initials: S
authors.lastname: Wright
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Susan
authors.initials: S
authors.lastname: Miller
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Rachel De La
authors.initials: Rde L
authors.lastname: Huerta
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Helen
authors.initials: H
authors.lastname: Houser
authors.affiliation: Arizona Department of Health Services.
authors.forename: Aarikha
authors.initials: A
authors.lastname: D'Souza
authors.affiliation: Arizona Department of Health Services.
authors.forename: Shoana
authors.initials: S
authors.lastname: Anderson
authors.affiliation: St Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Howard
authors.affiliation: Arizona Department of Health Services.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Komatsu
authors.affiliation: Maricopa County Department of Public Health.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
keywords: disease outbreak; healthcare worker-patient transmission; infants; neonates; pertussis