Cost of pertussis outbreak to local health departments is substantial

Local health department costs in response to pertussis outbreaks exceed $2,000 per case, according to a report in Morbidity and Mortality Weekly Report.

These data are derived from a survey of time spent responding to a school-based pertussis outbreak in Omaha, Nebraska, in late 2008, during which 26 students were diagnosed.

After notification of a 5-year-old student diagnosed with pertussis, the Douglas County Health Department’s response, per protocol, was to identify and contact close contacts. The response included a recommendation for chemoprophylaxis of close contacts and exclusion from school of students with a cough until a physician evaluated them.

The Douglas County Health Department spent a total of 1,032 hours responding to the outbreak. The total cost of the response was $52,131 for 24 cases (2 cases were identified after the survey was conducted) and included overhead, labor, and travel costs. This total amounted to 1% of the county health department’s annual program budget. The cost per case was $2,172.

Most of the time was spent tracing contacts and determining who was a “close contact” to target chemoprophylaxis. Close contact, according to response guidelines by the Centers for Disease Control and Prevention, are those who had direct face-to-face contact with an ill person for more than 1 hour or had direct contact with respiratory, oral, or nasal secretions from a symptomatic person.

Alternative response and chemoprophylaxis strategies should be explored in an effort to best use local health department resources, the report concludes.

CDC. Local health department costs associated with response to a school-based pertussis outbreak-Omaha, Nebraska, September-November 2008. MMWR. 2011;60(1);5-9.