Standardized Management of Patients and Employees Exposed to Pertussis

Haiduven, Donna; Hench, Carmen P.; Simpkins, Sandy M.; Stevens, David A.

doi:10.2307/30141568

Cited by 7 publications

(3 citation statements)

References 4 publications

(2 reference statements)

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“…Appropriate personnel were mobilized to deal with the outbreak, using previously developed procedures. 6 Beginning on May 30, 3,179 hospital employees received antibiotic prophylaxis over the next 4 weeks, after which the outbreak rapidly resolved. Because of the high frequency of intolerance to erythromycin, we elected to administer azithromycin (500 mg on day 1, followed by 250 mg on each of the next 4 days).…”

Section: Description Of the Outbreakmentioning

confidence: 99%

Azithromycin Prophylaxis During a Hospitalwide Outbreak of a Pertussis-Like Illness

Martinez

Kemper

Haiduven

et al. 2001

Infect. Control Hosp. Epidemiol.

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A questionnaire regarding tolerability and adherence was administered for 5 days to hospital employees who received azithromycin prophylaxis during a hospitalwide outbreak of a pertussis-like illness. Analysis of the 239 responses from those having received prophylactic azithromycin determined that it was well tolerated and accounted for a minimal loss of days worked; 81.5% were fully adherent with the regimen.

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Section: Description Of the Outbreakmentioning

confidence: 99%

Azithromycin Prophylaxis During a Hospitalwide Outbreak of a Pertussis-Like Illness

Martinez

Kemper

Haiduven

et al. 2001

Infect. Control Hosp. Epidemiol.

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“…Haiduven and colleagues reported that, between 1989 and 1997, their medical center had 49 pertussis exposures that originated in pediatric units or clinics. 22 Our experience is similar: 74 employees were exposed to 25 patients with pertussis between 1994 and 1998. 23 We found pertussis to be the third most common disease resulting in HCW exposure, following only varicellazoster and tuberculosis.…”

Section: Lessons F R O M N O S O C O M I a L Outbreaksmentioning

confidence: 64%

Pertussis: A Continuing Hazard for Healthcare Facilities

Weber¹,

Rutala²

2001

Infect. Control Hosp. Epidemiol.

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In 1999,7,288 cases of pertussis were reported to the Centers for Disease Control and Prevention (CDC).1 High rates of pertussis, compared with other pediatric vaccinepreventable diseases, continued to occur even though, since 1995, the coverage rate with at least three doses of a pertussis-containing vaccine has been greater than 95% among US children aged 19 to 35 months. 2The continuing high rates of pertussis in the United States pose a challenge for infection control professionals to develop new strategies to recognize and manage nosocomial outbreaks of pertussis. In this issue, Martinez and colleagues describe a hospitalwide outbreak of a Bordetella pertussis-like illness and report that the use of postexposure prophylaxis with azithromycin was tolerated well and resulted in few healthcare workers (HCWs) missing work. 3 C H A N G I N G EPIDEMIOLOGY OF PERTUSSIS: IMPORTANCE OF I N F E C T I O N I N ADULTSSince 1980, the number of reported cases of pertussis has increased in the United States. Possible reasons for this rise could include increased awareness of pertussis among healthcare providers, increased use of more sensitive diagnostic tests, and better reporting of cases to health departments.1 Because vaccine-induced immunity wanes within 5 to 10 years after pertussis vaccination, most adolescents and adults are susceptible to disease. 45 In contrast to the period 1990 through 1993, during 1994 through 1996, the incidence of pertussis reported to the CDC among preschool-aged children did not change, but the incidence among adolescents aged 10 to 19 years and adults increased by more than 90%. 6 An analysis of surveillance data from 1989 to 1998 in Massachusetts also noted that the incidence in children remained stable, whereas the incidence in adolescents and adults increased; indeed, by 1998, 92% of cases occurred in adolescents and adults. 7Pertussis is increasingly recognized as a case of chronic cough in adults. "11 Serological studies of prolonged cough illnesses in US adolescents and adults indicated that between 12% and 26% result from B pertussis infection.1215 Studies in other developed countries have produced similar results.11 The varying incidence rates reported depend, in part, on differences in study populations (eg, age), clinical definitions of disease (eg, duration of cough), and laboratory criteria for diagnosis. 16Pertussis in young children remains a serious disease. Common complications include pneumonia, 9.4%; seizures, 2.3%; and encephalopathy, 0.5%. Death occurred in 0.9% of children, all under 6 months of age.17 Adults with pertussis frequently experience prolonged cough, sleep disturbed by cough, and cough followed by choking or vomiting. 18 Complications have been reported to be more common in adults than adolescents (28% vs 16%), with pneumonia occurring in 5% to 9% of persons older than 30 years of age.19 Subclinical pertussis may be common in adults with household exposure. 20Adolescents and young adults play an important role in the transmission of pertussis, because immu...

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“…In this issue, Haiduven and colleagues report that their institution had 49 pertussis exposures over a 9-year period from 1989 to 1997. 18 Our experience is similar: 40 employees were exposed to 15 patients with pertussis from 1994 to 1997.…”

Section: Pertussis In Healthcare Facilitiesmentioning

confidence: 65%