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Outbreak of Pertussis Among Healthcare Workers in a Hospital Surgical Unit

Published online by Cambridge University Press:  21 June 2016

F. Brian Pascual ,
Candace L. McCall ,
Aaron McMurtray ,
Tony Payton ,
Forrest Smith  and
Kristine M. Bisgard
F. Brian Pascual*
Affiliation:
Bacterial Vaccine–Preventable Diseases Branch, National Immunization Program, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Candace L. McCall
Affiliation:
Epidemiology Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Epidemiology Division, Air Force Institute for Operational Health, Brooks City-Base, San Antonio, Texas
Aaron McMurtray
Affiliation:
Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Department of Neurology, University of California–Los Angeles School Of Medicine, Los Angeles, California
Tony Payton
Affiliation:
Division of Prevention, Ohio Department of Health, Columbus, Ohio
Forrest Smith
Affiliation:
Division of Prevention, Ohio Department of Health, Columbus, Ohio
Kristine M. Bisgard
Affiliation:
Bacterial Vaccine–Preventable Diseases Branch, National Immunization Program, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-61, Atlanta, Georgia30333 (fpascual@gwu.edu)
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Abstract

Background.

In September 1999, a pertussis outbreak was detected among surgical staff of a 138-bed community hospital. Patients were exposed to Bordetella pertussis during the 3-month outbreak period.

Objective.

To describe the outbreak among surgical staff, to evaluate implemented control measures, and to determine whether nosocomial transmission occurred.

Methods.

Clinical pertussis was defined as acute cough illness with a duration of 14 days or more without another apparent cause; persons with positive culture, PCR, or serologic test results were defined as having laboratory-confirmed pertussis. Surgical healthcare workers (HCWs) were interviewed regarding pertussis symptoms, and specimens were obtained for laboratory analysis. Patients exposed to B. pertussis during an ill staff member's 3-week infectious period were interviewed by phone to determine the extent of nosocomial spread.

Participants.

A total of 53 HCWs assigned to the surgical unit and 146 exposed patients. HCWs with pertussis were defined as case subjects; HCWs without pertussis were defined as non-case subjects.

Results.

Twelve (23%) of 53 HCWs had clinical pertussis; 6 cases were laboratory confirmed. The median cough duration in the 12 case subjects was 27 days (range, 20-120 days); 10 (83%) had paroxysms. Eleven (92%) of 12 case subjects and 28 (86%) of 41 non-case subjects received antibiotic treatment or prophylaxis. Seven case subjects (58%) reported they always wore a mask when near patients. Of 146 patients potentially exposed to pertussis from the 12 case subjects, 120 (82%) were interviewed; none reported a pertussis-like illness.

Conclusions.

Surgical staff transmitted B. pertussis among themselves; self-reported data suggests that these HCWs did not transmit B. pertussis to their patients, likely because of mask use, cough etiquette, and limited face-to-face contact. Control measures might have helped limit the outbreak once pertussis was recognized.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 6 , June 2006 , pp. 546 - 552
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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