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APHA Scientific Session and Event Listing

Recorded presentation

Barbara Butwinick, RN, BA, BSN¹, Chassea Golden, RN, MSN, MPH¹, Katherine Schmidt, RN, MS, MPH¹, Donna Caron, RN, MSN², Venus Gray, RN, MSN¹, and M. Anita Barry, MD, MPH¹. (1) Communicable Disease Control Division, Boston Public Health Commission, 1010 Massachusetts Ave, 2nd Floor, Boston, MA 02118, 617-534-2647, CGolden@BPHC.org, (2) Communicable Disease Control, Boston Public Health Commisssion, 1010 Massachusetts Ave, Boston, Ma02118, Boston, MA 02118

Pertussis is a potentially life threatening illness when acquired during the first year of life. Person-to-person transmission occurs through direct/droplet contact with nasopharyngeal secretions from an infected person; crowded conditions facilitate spread. In December, 2004, the Boston Public Health Commission (BPHC) was notified of suspect pertussis in a 4 month-old residing in a family shelter. The shelter had 18 staff members and housed 24 families totaling 70 people, ranging in age from newborns to 60 years-old. When outbreaks occur, public health nurses perform disease investigation, surveillance, outreach and health teaching needed to contain the disease. However, pertussis in a family shelter presents unique challenges for disease investigation and implementation of control measures. Methods: A cough survey identified nine of eighteen staff and nine of sixty-six residents coughing. Pertussis serologies and nasal cultures for diagnosis were obtained on all symptomatic staff and residents. Results: Three staff members and another resident were laboratory confirmed; two other staff became clinical cases. Eighteen (18) staff and 66 residents received prophylaxis. Active surveillance continued for six weeks. Besides prophylaxis, control measures included closing the shelter to susceptible new admissions, excluding symptomatic staff while infectious, educating shelter staff and residents, and immunizations. Major barriers to control included lack of insurance and primary healthcare, multiple life stressors for residents, expensive medication, out movement to other shelters, and limited ability to cohort. Conclusion: Collaboration among public health staff, community based healthcare providers, health care institutions, shelter staff, and residents resulted in no additional cases.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe four public health interventions to control a pertussis outbreak in a family shelter
• State five barriers in the control of a communicable disease in a shelter

Keywords: Communicable Disease, Homeless

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation