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Surveillance for Transmission and antibiotic Adverse Events Among Neonates and Adults Exposed to a Healthcare Worker With Pertussis

Published online by Cambridge University Press:  02 January 2015

Dara S. Friedman ,
C. Robinette Curtis ,
Stephanie L. Schauer ,
Susan Salvi ,
Henry Klapholz ,
Thomas Treadwell ,
Jerry Wortzman ,
Kristine M. Bisgard  and
Susan M. Lett
Dara S. Friedman*
Affiliation:
Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
C. Robinette Curtis
Affiliation:
Epidemic Intelligence Service, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Stephanie L. Schauer
Affiliation:
Division of Epidemiology and Immunization, Bureau of Communicable Disease Control, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts
Susan Salvi
Affiliation:
Metrowest Medical Center, Framingham, Massachusetts
Henry Klapholz
Affiliation:
Metrowest Medical Center, Framingham, Massachusetts
Thomas Treadwell
Affiliation:
Metrowest Medical Center, Framingham, Massachusetts
Jerry Wortzman
Affiliation:
Metrowest Medical Center, Framingham, Massachusetts
Kristine M. Bisgard
Affiliation:
Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Susan M. Lett
Affiliation:
Division of Epidemiology and Immunization, Bureau of Communicable Disease Control, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts
*
Massachusetts Department of Public Health, 305 South Street, Jamaica Plain, MA 02130
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Abstract

Background:

During a hospital obstetric rotation, a medical student demonstrated classic symptoms of pertussis. The diagnosis was confirmed by isolation of Bordetella pertussis. Because this exposure occurred in a high-risk hospital setting, control measures were undertaken to prevent transmission and illness.

Objectives:

To identify secondary cases of pertussis, to determine compliance with chemoprophylaxis recommendations, and to monitor for adverse events associated with chemoprophylaxis following a hospital exposure to pertussis.

Patients:

More than 500 individuals were potentially exposed, including 168 neonates; antimicrobial chemoprophylaxis was administered to 281 individuals. Fifty-eight neonates and 194 adults began azithromycin chemoprophylaxis; 18 neonates and 2 adults began erythromycin chemoprophylaxis.

Methods:

Active surveillance was instituted for (1) secondary cases of pertussis among healthcare coworkers, obstetric patients, their neonates, and labor companions and (2) antibiotic compliance and tolerance.

Results:

No secondary cases of pertussis were confirmed by laboratory tests; however, 26 suspected cases and 5 clinically compatible cases were identified. Antibiotic courses were completed by 95% of the individuals who initiated therapy. Neonates taking azithromycin had statistically significantly less gastrointestinal distress compared with neonates taking erythromycin (12% vs 50%; P = .002); there were no cases of infantile hypertrophic pyloric stenosis.

Conclusions:

Although it was not possible to assess the effectiveness of the antibiotic regimens, the lack of laboratory-confirmed secondary cases suggests control measures were successful. Data from the 58 neonates who received azithromycin suggest it may be well tolerated in this age group.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 967 - 973
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1. Guris, D, Strebel, PM, Bardenheier, B, et al. Changing epidemiology oi pertussis in the United States: increasing reported incidence among adolescents and adults, 1990-1996. Clin Infect Dis 1999;28:1230–1237.CrossRefGoogle Scholar
2. Yih, WK, Lett, SM, des Vignes, FN, Garrison, KM, Sipe, PL, Marchant, CD. The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989-1998. J Infect Dis 2000;182:1409–1416.Google Scholar
3. Cattaneo, LA, Reed, GW, Haase, DH, Wills, MJ, Edwards, KM. The sero-epidemiology of Bordetella pertussis infections: a study of persons ages 1-65 years. J Infect Dis 1996;173:1256–1259.Google Scholar
4. Senzilet, LD, Halperin, SA, Spika, JS, et al. Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clin Infect Dis 2001;32:1691–1697.CrossRefGoogle ScholarPubMed
5. Centers for Disease Control and Prevention. Pertussis: United States, 1997-2000. MMWR 2002;51:73–76.Google Scholar
6. Martinez, SM, Kemper, CA, Haiduven, D, Cody, SH, Deresinski, SC. Azithromycin prophylaxis during a hospitalwide outbreak of pertussislike illness. Infect Control Hosp Epidemiol 2001;22:781–783.Google Scholar
7. Gehanno, J-F, Pestel-Caron, M, Nouvellon, M, Caillard, J-F. Nosocomial pertussis in healthcare workers from a pediatric emergency unit in France. Infect Control Hosp Epidemiol 1999;20:549–552.Google Scholar
8. Shefer, A, Dales, L, Nelson, M, Werner, B, Baron, B, 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
9. Iambert, H. Epidemiology of a small pertussis outbreak in Kent County, Michigan. Public Health Rep 1965;80:365–369.CrossRefGoogle Scholar
10. Klein, JO. History of macrolide use in pediatrics. Pediatr Infect Dis J 1997;16:427–431.Google Scholar
11. Mahon, BE, Rosenman, MB, Kleiman, MB. Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis. J Pediatr 2001;139:380–384.Google Scholar
12. Centers for Disease Control and Prevention. Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin: Knoxville, Tennessee, 1999. MMWR 1999;48:1117–1121.Google Scholar
13. Hoppe, JE, Bryskier, A. In vitro susceptibilities of Bordetella pertussis and Bordetella parapertussis to two ketolides (HMR 3004 and HMR 3647), four macrolides (azithromycin, clarithromycin, erythromycin A, and roxithromycin), and two ansamycins (rifampin and rifapentine). Antimicrob Agents Chemother 1998;42:965–966.Google Scholar
14. Aoyama, T, Sunakawa, K, Iwata, S, Takeuchi, Y, Fujii, R. Efficacy of short-term treatment of pertussis with clarithromycin and azithromycin. J Pediatr 1996;129:761–764.Google Scholar
15. Bace, A, Zrnic, T, Begovac, J, Kuzmanovic, N, Culig, J. Short-term treatment of pertussis with azithromycin in infants and young children. Eur J Clin Microbiol Infect Dis 1999;18:296–298.Google Scholar
16. Langley, JM, Halperin, SA, Boucher, FD, Smith, B, the Pediatric Investigators Collaborative Network on Infections in Canada. Azithromycin is as effective as and better tolerated than erythromycin estolate for the treatment of pertussis. Pediatrics 2004;114:e96–e101.CrossRefGoogle ScholarPubMed
17. Pichichero, ME, Hoeger, WJ, Casey, JR. Azithromycin for the treatment of pertussis. Pediatr Infect Dis J 2003;22:847–849.Google Scholar
18. American Academy of Pediatrics. Antibacterial drugs for pediatric patients beyond the newborn period. In: Pickering, LK, ed. 2000 Red Booh: Report of the Committee on Infectious Diseases, ed. 25. Elk Grove Village, IL: American Academy of Pediatrics; 2000:657.Google Scholar
19. Weber, DJ, Rutala, WA. Vaccines for health care workers. In: Plotkin, SA, Orenstein, WA, eds. Vaccines, ed. 4. Philadelphia: W. B. Saunders; 2004:1511–1538.Google Scholar
20. Marchant, CD, Loughlin, AM, Lett, SM, et al. Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness. J Infect Dis 1994;169:1297–1305.Google Scholar
21. Halperin, SA, Bortolussi, R, Wort, AJ. Evaluation of culture, immunofluorescence, and serology for the diagnosis of pertussis. J Clin Microbiol 1989;4:752–757.Google Scholar
22. Kwantes, W, Joynson, DH, Williams, WO. Bordetella pertussis isolation in general practice: 1977-79 whooping cough epidemic in West Glamorgan. J Hyg (Lond) 1983;90:149–158.Google Scholar
23. Medical Research Council. The prevention of whooping-cough by vaccination: a Medical Research Council investigation. BMJ 1951:4721–4771.Google Scholar
24. Cherry, JD. Pertussis in the preantibiotic and prevaccine era, with an emphasis on adult pertussis. Clin Infect Dis 1999;28(suppl 2):S107–S111.Google Scholar
25. Edwards, KM, Decker, MD. Pertussis vaccine. In: Plotkin, SA, Orenstein, WA, eds. Vaccines, ed. 4. Philadelphia: W. B. Saunders; 2004:471–528.Google Scholar
26. Strebel, P, Guris, D, Wassilak, SG. Pertussis. In: Wallace, RB, Doebbeling, BN, Last, JM, eds. Maxcy-Rosenau-Last: Public Health & Preventive Medicine. Stamford, CT: Appleton & Lange; 1998.Google Scholar
27. Heininger, U, Cherry, JD, Stehr, K, et al. Comparative efficacy of the Lederle/Takeda acellular pertussis component DTP (DTaP) vaccine and Lederle whole-cell component DTP vaccine in German children after household exposure. Pediatrics 1998;102:546–553.Google Scholar
28. Fine, PEM, Clarkson, JA, Miller, E. The efficacy of pertussis vaccines under conditions of household exposure: further analysis on the 197890 PHLS/ERL study in 21 area health authorities in England. Int J Epidemiol 1988;17:635–642.Google Scholar
29. Vitek, C, Pascual, FB, Baughman, AL, Murphy, TV. Increase in deaths from pertussis among young infants in the United States in the 1990s. Pediatr Infect Dis J 2003;22:628–634.CrossRefGoogle ScholarPubMed
30. Centers for Disease Control and Prevention. Pertussis deaths: United States, 2000. MMWR 2002;51:616–618.Google Scholar
31. American Academy of Pediatrics. Pertussis. In: Pickering, LK, ed. 2003 Red Book: Report of the Committee on Infectious Diseases, ed. 26. Elk Grove Village, IL: American Academy of Pediatrics; 2003:472–486.Google Scholar
32. Centers for Disease Control and Prevention. Guidelines for the Control of Pertussis Outbreaks. Atlanta, GA: Centers for Disease Control and Prevention; 2002. Available at www.cdc.gov/nip/publications/pertussis/guide.htm.Google Scholar
33. Hospital Infection Control Practices Advisory Committee. Guideline for Infection Control in Health Care Personnel. Atlanta, GA: Centers for Disease Control and Prevention; 1998:312–313. Available at www.cdc.gov/ncidod/hip/guide/InfectControl98.pdf.Google Scholar
34. Centers for Disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia. MMWR 2004;53(RR-3):1–40.Google Scholar
35. Anti-Infective Drugs Advisory Committee. FDA Briefing Package: Zithromax (Azithromycin) Oral Suspension Single-Dose and Three-Day Treatment of Acute Otitis Media. Rockville, MD: LI.S. Food and Drug Administration; 2001. Available at www.fda.gov/ohrms/dockets/ac/01/briefing/3802bl_02_FDA.pdf.Google Scholar
36. Remington, JS, Klein, JO. Clinical Pharmacology of Antibacterial Agents in Infectious Diseases of the Fetus and Newborn Infant, ed. 4. Philadelphia: W. B. Saunders; 1995:1287–1336.Google Scholar
37. Hopkins, SJ. Clinical toleration and safety of azithromycin in adults and children. Review of Contemporary Pharmacotherapy 1994;5:383–389.Google Scholar