Successful control of a pertussis outbreak in a university children's hospital

OBJECTIVES: Healthcare workers (HCWs) are at high risk for acquisition and/or transmission of Bordetella pertussis. We report an outbreak of pertussis in a children's hospital involving three HCWs. DESIGN: Clinical and epidemiological observations. RESULTS: A 62-year-old nurse was suffering from a paroxysmal cough, choking, and significant sleep disturbances of 3 weeks duration; a diagnosis of pertussis was made by PCR. At the time of diagnosis, 25 HCWs working on the same ward as the index case were identified as having been exposed. Of these, seven complained of a current cough illness. PCR was positive for B. pertussis in two of them (both with paroxysmal cough), and they were treated with clarithromycin p.o. Asymptomatic HCWs received postexposure prophylaxis with azithromycin p.o. None of these HCWs, and none of the patients hospitalized on the index case's ward, developed a cough illness during the following 4 weeks. CONCLUSIONS: Pertussis should be suspected in HCWs with prolonged cough illness, and immediate action is required to limit spread of the disease.