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Two Nosocomial Pertussis Outbreaks and Their Associated Costs—King County, Washington, 2004

Published online by Cambridge University Press:  02 January 2015

Henry C. Baggett*
Affiliation:
Communicable Diseases, Epidemiology, and Immunization Section, Public Health—Seattle and King County, Seattle, Washington Preventive Medicine Residency, Office of Workforce and Career Development, Seattle, Washington International Emerging Infections Program, Thailand MOPH-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
Jeffrey S. Duchin
Affiliation:
Communicable Diseases, Epidemiology, and Immunization Section, Public Health—Seattle and King County, Seattle, Washington University of Washington, Seattle, Washington
William Shelton
Affiliation:
University of Washington, Seattle, Washington
Danielle M. Zerr
Affiliation:
University of Washington, Seattle, Washington Children's Hospital and Regional Medical Center, Seattle, Washington
Joan Heath
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, Washington
Ismael R. Ortega-Sanchez
Affiliation:
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Tejpratap Tiwari
Affiliation:
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Global Migration and Quarantine, CDC, 1600 Clifton Rd. NE MS E03, Atlanta, GA 30333 (hbaggett@cdc.gov)

Abstract

Objective.

Pertussis outbreaks in healthcare settings result in resource-intensive control activities, but studies have rarely evaluated the associated costs. We describe and estimate costs associated with 2 nosocomial pertussis outbreaks in King County, Washington, during the period from July 25 to September 15, 2004. One outbreak occurred at a 500-bed tertiary care hospital (hospital A), and the other occurred at a 250-bed pediatric hospital (hospital B).

Methods.

We estimated the costs of each outbreak from the hospitals' perspective through standardized interviews with hospital staff and review of contact tracing logs. Direct costs included personnel time and laboratory and medication costs, whereas indirect costs were those resulting from hospital staff furloughs.

Results.

Hospital A incurred direct costs of $195,342 and indirect costs of $68,015; hospital B incurred direct costs of $71,130 and indirect costs of $50,000. Cost differences resulted primarily from higher personnel costs at hospital A ($134,536), compared with hospital B ($21,645). Total cost per pertussis case was $43,893 for hospital A (6 cases) and $30,282 for hospital B (4 cases). Total cost per person exposed to a pertussis patient were $357 for hospital A (738 exposures) and $164 for hospital B (737 exposures).

Conclusions.

Nosocomial pertussis outbreaks result in substantial costs to hospitals, even when the number of pertussis cases is low. The cost-effectiveness of strategies to prevent nosocomial pertussis outbreaks, including vaccination of healthcare workers, should be evaluated.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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