Resource Consumption in the Infection Control Management of Pertussis Exposure Among Healthcare Workers in Pediatrics

Abstract

Exposure of HCWs to pertussis during contact with children who have the disease is largely unavoidable, and management of this exposure is resource intensive. Universal preexposure vaccination of HCWs is a better utilization of resources than is case-based postexposure management.

Mass spectrometry: a revolution in clinical microbiology?

“…These tools considered to be expensive and time-consuming have clearly evolved and represented a suitable evolution for routine identification. For example, different tests (e.g., GeneXpert TM system or BD GeneOhm ™ StaphSR) have been developed for rapid management of contagious diseases such as Clostridium difficile , Bordetella pertussis or Neisseria meningitidis (33,34) . These tests also allow MRSA to be detected from different sample types (e.g., blood, skin and soft tissue, nasal swabs) and to prevent unjustified prescriptions (e.g., detection of Enterovirus or Streptococcus agalactiae in pregnant women [35,36] ).…”

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,…”

“…In adults the disease generally lasts for four weeks, with 25% of patients developing complications 24 . It should be noted that even asymptomatic or mild cases may transmit B. pertussis to others, including family members 51,66,69,72,73,83,96 .…”

“…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 .…”

“…Although pertussis hospital outbreaks involve only a small number of individuals, they may be very costly due to the recommended investigation and control measures that involve the temporary removal of the professionals from the working environment, the use of prophylactic antibiotics and laboratory tests of infected cases 65 In the United States, pertussis outbreaks in HCPs were reported more than three decades ago 105 and reports of pertussis outbreaks involving HCPs have become increasingly common since the 1990s, especially during pertussis epidemics which occur every three to four years even in vaccinated populations 10,11,66,67,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81 .…”