BACKGROUND:
Unrecognized pertussis disease is a factor in maintaining ongoing pertussis transmission in the community. Health care providers may have unprotected exposure to persons with unrecognized pertussis disease, then transmit the disease to co-workers and other patients.

OBJECTIVE:
This presentation will demonstrate risk factors for pertussis transmission in health care settings, discuss the economic impact on facilities, and review the related burden on public health resources of pertussis outbreaks in health care facilities

METHOD:
Since 1999, Public Health-Seattle & King County has investigated increasing numbers of reports involving pertussis disease and exposures among health care workers. More than ten large outbreaks occurred have occurred that involved hospitals, public health clinics, or other outpatient settings with multiple coughing staff members. In several situations, call center activation was required as part of Public Health’s response in order to notify exposed persons and provide pertussis testing and mass prophylaxis for large numbers of patients and staff. Three outbreaks are discussed that involved multiple culture- or PCR-confirmed cases where transmission between patients and staff could be documented. The fiscal, laboratory, and personnel resources required for such a response are reviewed.

RESULT:
Pertussis transmission in health care settings is an emerging issue for health care institutions and local public health jurisdictions. The economic impact and the strain on staff and material resources are considerable, both for Public Health and for private institutions.

CONCLUSION:
Earlier recognition of pertussis disease and stricter infection control practices may reduce pertussis transmission in health care settings.

LEARNING OBJECTIVES:
Understands factors unique to pertussis disease and its diagnosis and treatment that may increase the risk of transmission in health care settings. Is able to discuss the economic impact of pertussis outbreaks in healthcare facilities. Relates better adherence to “respiratory etiquette” guidelines and clear policies for coughing health care workers to better pertussis control in the community.