Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-29T19:51:19.792Z Has data issue: false hasContentIssue false
  • English
  • Français

Health and Economic Consequences of an Outbreak of Pertussis Among Healthcare Workers in a Hospital in France

Published online by Cambridge University Press:  21 June 2016

Alexandra Ward ,
Jaime Caro ,
Laurence Bassinet ,
Bruno Housset ,
Judith A. O'Brien  and
Nicole Guiso
Alexandra Ward*
Affiliation:
Caro Research Institute, Concord, Massachusetts
Jaime Caro
Affiliation:
Caro Research Institute, Concord, Massachusetts
Laurence Bassinet
Affiliation:
Institut Pasteur, Paris, France
Bruno Housset
Affiliation:
Lung Disease Department, Creteil, France
Judith A. O'Brien
Affiliation:
Caro Research Institute, Concord, Massachusetts
Nicole Guiso
Affiliation:
Institut Pasteur, Paris, France
*
336 Baker Avenue, Concord, MA, 01742alexward@caroresearch
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Bordetella pertussis is highly contagious, and because immunity wanes after vaccination, it continues to be a cause of cough among adults.

Objective:

To describe the healthcare services used and productivity losses accrued by healthcare workers (HCWs) missing work due to pertussis.

Methods:

After 3 pertussis cases were confirmed among HCWs, all hospital employees and patients with a cough were screened between November 2000 and March 2001. Each potential case underwent diagnostic tests and received antibiotics (spiramycin or azithromycin) when appropriate. Symptomatic employees were not allowed to return to work until they received an antibiotic for at least 5 days. Services used (physician visits and calls, antibiotics, diagnostic tests, hospitalization, and treatment provided to their contacts) were combined with cost estimates (in 2002 euros) for these services in France.

Results:

Ninety-one potential cases were identified (77 HCWs, 12 patients, and 2 family members). Of them, 89% received antibiotics and 22% had at least one contact who was also treated. Approximately half (55%) of the HCWs who were cases missed 5 days of work. Four patients were admitted to the hospital as a result of the infection. The average medical cost was 297 euros per potential case: diagnostic tests accounted for 32% and hospitalization for 31%. Total cost (medical and productivity) was 46,661 euros for 91 cases, 42% from productivity losses. An investigation to identify these potential cases also accrued additional costs.

Conclusion:

Serious adverse health and economic consequences arose from transmission of pertussis among HCWs, their families, and patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 3 , March 2005 , pp. 288 - 292
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wirsing von Konig, CH, Halperin, S, Riffelman, M, Guiso, N. Pertussis of adults and infants. Lancet Infect Dis 2002;2:744–750.Google Scholar
2.Baron, S, Njamkepo, E, Grimprel, E, et al.Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination. Pediatr Infect Dis J 1998;17:412–418.CrossRefGoogle ScholarPubMed
3.Christie, CD, Glover, AM, Willke, MJ, Marx, ML, Reising, SF, Hutchinson, NM. Containment of pertussis in the regional pediatric hospital during the Greater Cincinnati epidemic of 1993. Infect Control Hosp Epidemiol 1995;16:556–563.CrossRefGoogle ScholarPubMed
4.Shefer, A, Dales, L, Nelson, M, Werner, B, Baron, R, Jackson, R. Use and safety of acellular pertussis vaccine among adult hospital staff during an outbreak of pertussis. J Infect Dis 1995;171:1053–1056.Google Scholar
5.Kurt, TL, Yeager, AS, Guenette, S, Dunlop, S. Spread of pertussis by hospital staff. JAMA 1972;221:264–267.CrossRefGoogle ScholarPubMed
6.Addiss, DG, Davis, JP, Meade, BD, et al.A pertussis outbreak in a Wisconsin nursing home. J Infect Dis 1991;164:704–710.CrossRefGoogle Scholar
7.Tanaka, Y, Fujinaga, K, Goto, A, et al.Outbreak of pertussis in a residential facility for handicapped people. Dev Biol Stand 1991;73:329–332.Google Scholar
8.Martinez, SM, Kemper, CA, Haiduven, D, Cody, SH, Deresinski, SC. Azithromycin prophylaxis during a hospital-wide outbreak of a pertussis-like illness. Infect Control Hosp Epidemiol 2001;22:781–783.Google Scholar
9.Lane, NE, Paul, RI, Bratcher, DF, Stover, BH. A survey of policies at children's hospitals regarding immunity of healthcare workers: are physicians protected? Infect Control Hosp Epidemiol 1997;18:400–404.Google Scholar
10.Gehanno, JF, Pestel-Caron, M, Nouvellon, M, Caillard, JF. Nosocomial pertussis in healthcare workers from a pediatric emergency unit in France. Infect Control Hosp Epidemiol 1999;20:549–552.Google Scholar
11.Wright, SW, Decker, MD, Edwards, KM. Incidence of pertussis infection in healthcare workers. Infect Control Hosp Epidemiol 1999;20:120–123.CrossRefGoogle ScholarPubMed
12.Directive 2000/54/EC of the European Parliament and of the Council of 18 September 2000 on the protection of workers from risks related to exposure to biological agents at work. Official Journal of the European Communities 2000;L262:21–45.Google Scholar
13.Lee, LH, Pichichero, ME. Costs of illness due to Bordetella pertussis in families. Archives of Family Medicine 2000;9:989–996.Google Scholar
14.Thomas, PF, McIntyre, PB, Jalaludin, BB. Survey of pertussis morbidity in western Sydney. Medical Journal of Australia 2000;173:74–76.CrossRefGoogle ScholarPubMed
15.De Melker, HE, Versteegh, FGA, Conyn-van Spaendonck, MAE, et al.Specificity and sensitivity of high levels of immunoglobulin G antibodies against pertussis toxin in a single serum sample for diagnosis of infection with Bordetella pertussis. J Clin Microbiol 2000;38:800–806.Google Scholar
16.La Caisse Nationale de L'Assurance Maladie. Nomenclatures Générale des Actes Professionnels/de Biologie Médicale. Paris: La Caisse Nationale de L'Assurance Maladie; 1999.Google Scholar
17.Baumélou, A, Petitcollot, N. Spiramycin and azithromycin. In: GNP Encyclopédie Pratique du Médicament, ed. 12. Paris: Vidal; 2001:804, 811–812.Google Scholar
18.Santé du Ministère. The National Scale of Relative Costs by Diagnosis Related Group (DRG) [in French]. Paris: Les Journaux Officiels; 2000. Available at www.sante.gouv.fr.Google Scholar
19.Rasolofoarison, J, Seroussi, G. Wages in Companies in 2000: Hourly Wages Still Buoyant [in French]. Paris: Département de l'Emploi et des revenus d'activité, INSEE; 2002. Available at www.insee.fr/en/ffc/Fiche_doc.asp?docjd=735&path=/fr/ffc/docs_ffc/ip833.pdf. Accessed August 2, 2002.Google Scholar
20.Bassinet, L, Matrat, M, Njamkepo, E, Aberrane, S, Housset, B, Guiso, N. Nosocomial pertussis outbreak among adult patients and healthcare workers. Infect Control Hosp Epidemiol 2004;25:995–997.CrossRefGoogle ScholarPubMed
21.Bolyard, E, Tablan, OC, Williams, WW, et al.Guideline for infection control in healthcare personnel. Infect Control Hosp Epidemiol 1998;19: 429–430.CrossRefGoogle ScholarPubMed
22.Farizo, KM, Cochi, SL, Zell, ER, Brink, EW, Wassilak, SG, Patriarca, PA. Epidemiological features of pertussis in the United States, 1980-1989. Clin Infect Dis 1992;14:708–719.Google Scholar
23.Yih, WK, Lett, SM, des Vignes, FN, Garrison, KN, Sip, PL, Marchant, CD. The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989-1998. J Infect Dis 2000;182:1409–1416.Google Scholar
24.Grimprel, E, Begue, P, Anjak, I, Betsou, F, Guiso, N. Comparison of polymerase chain reaction, culture, and western immunoblot serology for diagnosis of Bordetella pertussis infection. J Clin Microbiol 1993;31: 2745–2750.Google Scholar
25.Samore, MH, Siber, GR. Pertussis. In: Harrison's Principles of Medicine, ed. 13. New York: McGraw-Hill; 1994:658–661.Google Scholar
26.Steketee, RW, Wassilak, SG, Adkins, WN Jr, et al.Evidence for a high attack rate and efficacy of erythromycin prophylaxis in a pertussis outbreak in a facility for the developmentally disabled. J Infect Dis 1988; 157:434–440.Google Scholar
27.Halperin, SA, Wang, EE, Law, B, et al.Epidemiological features of pertussis in hospitalized patients in Canada, 1991-1997: report of the Immunization Monitoring Program-Active (IMPACT). Clin Infect Dis 1999;28:1238–1243.Google Scholar
28.Pichichero, ME, Treanor, J. Economic impact of pertussis. Arch Pediatr Adolesc Med 1997;151:35–40.Google Scholar
29.Wirsing von Konig, CH, Postels-Multani, S, Bock, HL, Schmitt, HJ. Pertussis in adults: frequency of transmission after household exposure. Lancet 1995;346:1326–1329.CrossRefGoogle ScholarPubMed