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Whooping-cough risk spreads in Seattle after doctor infects hospital workers

Posted - Jul. 29, 2004 at 2:20 p.m.



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Jul. 29--An additional 200 patients may have been exposed to Swedish Medical Center employees infected with whooping cough. That brings the total possibly exposed in the past few weeks to nearly 400 patients and employees of the hospital's First Hill Campus.

A hospital official said yesterday two employees of Swedish's obstetrics-gynecology unit, the Women and Infants Center, were exposed to an emergency-room physician with a confirmed case of the disease and now have symptoms themselves. The two employees had contact with the ob-gyn patients.

All of the estimated 200 additional patients are being contacted and asked to come to the hospital for protective antibiotics and evaluation. Employees of the ob-gyn unit also are being interviewed to see who might have had contact with the two new suspect cases.

Newborn infants, who have little immunity, are especially vulnerable to whooping cough, or pertussis.

"We want to jump on this right away. We want to be as proactive as possible for the protection of the patients," said Dr. Martin Siegel, the medical director of epidemiology at Swedish.

The disease can't be transmitted to the fetus.

Results of pertussis tests on the ob-gyn workers should be known by tomorrow, Siegel said. He said the workers had contact with the infected emergency-room physician outside the hospital.

Siegel said pregnant women with pertussis may have an increased risk of pneumonia because, with swollen abdomens, they cannot normally exhale germs as well as others. But the risk of such a complication is "very small, if at all," said Dr. Jeff Duchin, director of communicable-disease control for Public Health -- Seattle & King County.

Concerns about the bacterial illness spreading in the hospital began when an emergency-room physician was diagnosed with pertussis last Saturday.

Swedish officials have contacted all but 10 of 107 patients and all 90 employees who had contact with the doctor from about July 1 through July 18. None has tested positive for the disease, though about half of the patients still have not come into the hospital for evaluation and antibiotics, Siegel said.

"It's a fluid situation," he said. "I suspect we may find an additional case or two."

Duchin said other possible contacts of the physician outside the hospital also are being notified. These include some patients of Seattle OB/GYN, where the ill physician was recently examined, according to a doctor at the clinic.

Transmission of the bacteria that cause pertussis is usually through droplets expelled when an infected person coughs. Someone must be in fairly close contact with the patient to contract the disease, Duchin said.

Many adults who have pertussis don't realize they have the disease because their symptoms are much milder than those in infants and young children. Duchin said that has contributed to spread of the disease, especially in infants.

A record 43 babies had whooping cough last year out of a total of 282 cases in King County, a significant increase over the cases in 2002 and 2001. Statewide, from 400 to 830 cases are reported each year, including an average of one death.

Duchin said anyone with respiratory-tract infections, especially cough illnesses, should avoid contact with infants. Anyone with a cough lasting two weeks or longer should see a physician for evaluation of possible pertussis, he said.

WHOOPING-COUGH SYMPTOMS:

--Appear an average of six to 21 days after exposure.

--They start with a cough and runny nose, followed by severe coughing that can last more than a month.

--The person has little or no fever.

--Vomiting may occur after severe coughing.

--A "whoop" sound may occur when breathing in.

--Teenagers and adults typically have milder symptoms.

Source: Public Health -- Seattle & King County

MORE INFORMATION:

--Swedish Medical Center has set up a whooping-cough hotline: 206-215-2621.

--Information also is available at Public Health -- Seattle & King County: 206-296-4949, tape 3, or at www.metrokc.gov/health/prevcont/pertussis.htm

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(c) 2004, The Seattle Times. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprintskrtinfo.com.

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