940. Provider Awareness and Altered Practice Following a 2011-2012 Bordetella pertussis Outbreak, New York City
Session: Poster Abstract Session: Respiratory Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • 940. Provider Awareness and Altered Practice Following a 2011-2012 Bordetella pertussis Outbreak, New York City.pdf (600.2 kB)
  • Background: In January 2013, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) surveyed providers to assess if increased awareness and changes in clinical practices contributed to an elevated Bordetella pertussis incidence 270% over baseline following a 2011-2012 outbreak.

    Methods: A twenty-question web-based survey was designed in FeedbackServer 5.  The survey was distributed to NYC medical providers via multiple e-mail list-serves created and maintained by DOHMH, which were chosen for rapid survey distribution.  The list-serves were not mutually exclusive and included non-medical providers.  Analysis was limited to unique respondents who completed all survey questions and indicated current practice in a hospital or outpatient facility located in NYC.  Analyses were conducted using SAS v9.2.

    Results: A total of 1,316 responses were received, of which 429 (33%) met the inclusion criteria.  Respondents provided care for pediatric (54%) and/or adult (69%) populations and worked in hospital (37%) and/or outpatient (80%) settings.  Eighty-four percent of respondents were aware of the pertussis outbreak.  Seventy-three percent reported that after the outbreak, they were more likely to consider pertussis in a patient with prolonged cough illness.  Twenty-two percent reported an increased frequency of diagnostic testing.  Twelve percent changed the type of diagnostic test ordered for pertussis, of which 33% and 64% were more likely to test with bacterial culture and/or polymerase chain reaction (PCR), respectively.  Health advisory alerts and media reports were the most frequent reasons for awareness of the outbreak and altered clinical practices.  Limitations of this survey include: 1) respondents may not be representative of the broader provider community; and 2) the survey response rate cannot be determined due to the nature of list-serves used.

    Conclusion: High awareness of the outbreak, increased clinical suspicion of pertussis, and increased frequency of diagnostic testing likely contributed to the elevated incidence of pertussis cases reported following an outbreak in NYC.  Advisory alerts and media reports were successful methods for providing information to providers.

    Robert Arciuolo, MPH, CPH1,2, Jennifer Rosen, MD2 and Jane Zucker, MD, MSc2,3, (1)Centers for Disease Control and Prevention/ Council of State and Territorial Epidemiologists Applied Epidemiology Fellowship, Atlanta, GA, (2)Bureau Of Immunization, New York City Department of Health and Mental Hygiene, Long Island City, NY, (3)National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA


    R. Arciuolo, None

    J. Rosen, None

    J. Zucker, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.