Economic impact of pertussis
M. E. Pichichero and J. Treanor
Department of Microbiology and Immunology, University of Rochester Medical Center, NY, USA.
OBJECTIVE: To assess the economic consequences of pertussis in Monroe
County, New York (population, 713969), during a 6-year period (1989-1994).
METHODS: Cases of pertussis were identified retrospectively by passive
reporting and diagnosis based on culture, positive results of direct
fluorescent antibody testing, or Centers for Disease Control and Prevention
clinical criteria (cough for > 14 days otherwise unexplained or for >
7 days with paroxysms or whoop epidemiologically linked to a
laboratory-confirmed case). One hundred seven (50%) of 216 subjects with
identified cases of pertussis completed questionnaires and had medical
records reviewed to ascertain the costs of illness, including physician
office visits, laboratory tests, medications, hospitalization, emergency
department visits, additional child care, and lost days from school
(children) or from work (parents or adult cases). RESULTS: Ninety-three
(87%) of the pertussis case occurred in children. The average duration of
illness before diagnosis was 21.3 days (range, 12-37 days). One hundred one
patients (94%) saw a physician at least once; overall, the average number
of visits per case was 3.2 (range, 1-15). Ninety-seven patients (91%)
received at least 1 course of antibiotic therapy (average cost for all
antibiotics, $95/case), and all took symptomatic treatment (average cost,
$48/case). Fifteen patients (14%) required hospitalization; average cost
per admission was $13425 (range, $1732-$69637). Thirty patients (28%) were
seen in emergency departments; average cost was $202 (range, $69-$289).
Additional child care costs ranged from $12 to $2688. For 50 families, 1
adult lost workdays because of illness or to provide child care for an
average of 8.3 days (range, 1-45 days). For 4 families, 2 adults lost an
average of 44 days from work (range, 10-120 days). The cumulative number of
lost workdays was 758 in association with the 107 cases of pertussis. The
average full recovery time from illness was 72.9 days (range, 25-115 days).
CONCLUSIONS: Total direct and indirect cost for 107 cases of pertussis in
Monroe County was $381052. The economic burden of pertussis is substantial
and encourages broader use of vaccination to prevent disease.
Pertussis Vaccination for Health Care Workers
Sandora et al.
Clin. Microbiol. Rev. 2008;21:426-434.
ABSTRACT
| FULL TEXT
IEIIS Meeting minireview: Bordetella evolution: lipid A and Toll-like receptor 4
MacArthur et al.
Innate Immunity 2007;13:243-247.
ABSTRACT
Rationale for Use of Tdap Booster Vaccines for Adolescent Immunization: Overview of Efficacy, Safety, and Clinical Use
Hitchcock
CLIN PEDIATR 2006;45:785-794.
ABSTRACT
Acellular Pertussis Vaccine Booster Combined With Diphtheria and Tetanus Toxoids for Adolescents
Pichichero et al.
Pediatrics 2006;117:1084-1093.
ABSTRACT
| FULL TEXT
Relaxed Acyl Chain Specificity of Bordetella UDP-N-acetylglucosamine Acyltransferases
Sweet et al.
J. Biol. Chem. 2002;277:18281-18290.
ABSTRACT
| FULL TEXT
Invited review: The molecular genetics and role in infection of lipopolysaccharide biosynthesis in the Bordetellae
Preston and Maskell
Innate Immunity 2001;7:251-261.
Costs of Illness Due to Bordetella pertussis in Families
Lee and Pichichero
Arch Fam Med 2000;9:989-996.
ABSTRACT
| FULL TEXT
Genetic Basis for Lipopolysaccharide O-Antigen Biosynthesis in Bordetellae
Preston et al.
Infect. Immun. 1999;67:3763-3767.
ABSTRACT
| FULL TEXT
Identification and Cloning of waaF (rfaF) from Bordetella pertussis and Use To Generate Mutants of Bordetella spp. with Deep Rough Lipopolysaccharide
Allen et al.
J. Bacteriol. 1998;180:35-40.
ABSTRACT
| FULL TEXT
