News Briefs: Added Tdap booster considered for HCWs

Pertussis immunity wanes even one year after immunization with Tdap, so routine re-immunization of adults is not cost-effective, an advisory panel for the Centers for Disease Control and Prevention concluded.

But CDC continues to recommend a one-time dose of Tdap for health care workers, and a workgroup with the Advisory Committee on Immunization Practices (ACIP) may consider additional booster shots of Tdap for health care workers, especially those who work with infants, who are at greatest risk of pertussis infection and severe disease.

Less than half of health care workers have received Tdap, says Mark Sawyer, MD, professor of pediatrics at the University of California – San Diego and chair of the ACIP workgroup on pertussis vaccines.

There's no "systematic data" on transmission of pertussis from health care workers to patients, says Sawyer. "I have heard anecdotal reports of transmission from an infectious health care worker to patients. We don't really know what the overall frequency is.

CDC is focused on preventing pertussis in infants by vaccinating people who have contact with infants as well as vaccinating pregnant women.

More than 48,000 pertussis cases were reported in 2012, the highest number since 1955. Washington, Vermont and Colorado reported epidemic levels of pertussis. The greatest incidence was among infants less than one year of age.

CDC updating ID guidance

Should you restrict personnel who are colonized with C. difficile? Should you screen health care workers for Methicillin-resistant staphylococcus aureus (MRSA)? What should you provide as post-exposure prophylaxis for Group A streptococcus?

Those questions and others are being addressed as the Centers for Disease Control and Prevention updates its 1998 Guideline for Infection Control in Healthcare Personnel. That guideline is currently the oldest one that has not yet been updated. It addresses 22 infectious diseases.

The document will continue to be a key resource for occupational health and infection control, with an emphasis on ease of use, says David Kuhar, MD, medical epidemiologist. "We're committed to putting out a high-quality, useful document for the [health care] community," he says.

There is currently no timeline for the new guideline.

Final rule issued on wellness incentives

The Obama Administration issued a final rule allowing employers to create even greater incentives for wellness and smoking cessation.

Employers may give an incentive of up to 30% of the cost of an individual health care premium (up from a limit of 20%) for employees who participate in a wellness program, and an incentive of up to 50% for programs that prevent or reduce tobacco use, according to the rule from the U.S. Departments of Health and Human Services, Labor and the Treasury.

The rule includes provisions to ensure that wellness programs are "reasonably designed to promote health or prevent disease" and are not discriminatory. It becomes effective on Jan. 1, 2014. A copy of the final rule is available at