An Outbreak of Pertussis in a Hematology-Oncology Care Unit: Implications for Adult Vaccination Policy

Abstract

A pertussis outbreak in a hematology-oncology care unit involved 10 (8.5%) of 117 employees. The source was an employee who contracted pertussis via a family contact. No screened patients contracted pertussis, likely because of isolation measures. Hospitals should consider employee immunization with acellular vaccine in healthcare settings where pertussis has high rates of morbidity and mortality.

Immunogenicity of recombinant hepatitis B vaccine (rHBV) in recipients of unrelated or related allogeneic hematopoietic cell (HC) transplants

“…25 The 1990 measles epidemic in the United States (reviewed in Ada 26 ), the spread of measles in a bone marrow transplantation (BMT) unit in São Paolo, 27 the outbreak of varicella in a daycare center 28 in which the index case and the majority of affected children had previously received varicella virus vaccine live, and the recent increase in pertussis in healthy 29 individuals and oncology patients 30 underscore the importance of systematic evaluation of the duration of positive antibody titers following vaccination, even in immunocompetent individuals. Despite the retrospective nature of this study, it underscores the need to obtain prevaccine and postvaccine titers in order to ensure seroconversion and long-term immunity against hepatitis B virus and suggests that studies using higher doses of rHBV in patients older than 40 years or with a prior history of GVHD, a strategy efficacious in dialysis patients, should be undertaken (reviewed in Poland and Jacobson 1 and Yu et al 8 ).…”

Factors affecting uptake of recommended immunizations among health care workers in South Australia

“…[23][24][25] With low uptake of pertussis vaccine among HCWs 13,18,26 nosocomial outbreaks have been reported. 4,[27][28][29][30][31] In the workplace environment, it is plausible that vaccination recommendations and practices for some vaccinations may influence the uptake of other vaccines. In addition, if there exists a culture of poor support from management and peers and there is misinformation about official recommendations and vaccination benefits, then it may be difficult for staff to seek out this preventative health measure.…”

Should acellular pertussis vaccine be recommended to healthcare professionals?

“…HCPs may contract pertussis and transmit the disease to their patients and hospital colleagues, thus causing disease outbreaks 1 24 ; however, other HCPs, such as nurses, physiotherapists and people who are in direct contact with patients are at greater risk of becoming infected 63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105 . Adults generally develop a milder form of the disease than children, however morbidity and the chances of complications are high 1,7,21,22,…”

“…The majority of pertussis outbreaks associated with HCPs have been reported in pediatric hospitals 8,63,68,69,87,83,96 , particularly in neonatal care units and intensive care services 65,66,67,69,72,88,94,98,103 with hospitalized infants in units that treat immunocompromised or institutionalized patients 64,95,104 . Recently, a pertussis outbreak was also detected among HCPs who worked in a laboratory specialized in pertussis diagnosis 96 .…”

“…Despite this, prophylactic measures to avoid infections are not always adopted in a timely manner 63,64,65,66,67,68,69,70,71,72,73,74,75,76 .…”