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Bor Pertussis

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pertusis

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M. B. COLLEGE OF PARAMEDICAL AND NURSING EDUCATION, KOTA

1. INTRODUCTIONPertussis, also known as whooping cough is a highly contagious bacterial disease mainly caused by Bordetella pertussis. It's characterized by severe coughing spells, which can sometimes end in a "whooping" sound when the person breathes in.Whooping cough is also known as 100 days cough.Habbit pattern of coughing may longer or subscquent weeks & month,so chiniese call it; 100 DAYS COUGH.

2. DEFINITIONPertusis is acute highly contagious disease which cause classic spasm (paroxyms) of uncontrollable coughing, that is violent and persistence followed by a sharp, high pitched intake of air which create characteristic WHOOP sound.Children who have typically illness of pertusis try to take deep breath between cough result in whooping sound.3. AGENTAgent of pertusis are-Bordetella Pertusis(gm +ve, rod shaped, non motile)Bordetella ParapertusisHaemophillus HaemolyticusAdeno VirusBronchi Septica

Fig: Bordetella Pertusis 4. INCUBATION PERIODThe incubation period is typically seven to ten days in infants or young children, after which there are usually mild respiratory symptoms, mild coughing, sneezing, or runny nose. 5. MODE OF TRANSMISSION

Tiny droplets that comes from mouth & nose of infected patient.Respiratory Aerosole (Droplets)Close ContactIt spreads through close contact with oral secretions or respiratory droplets. So it's easily spread through the cough, especially when people are in close contact, like living in the same house with a person who has whooping cough. It can also be spread through sneezes.

DROPLET INFECTION

7. AGE GROUP & SEXIt is primarily disease of pre schoolar (3-5 years) & may occur in infants, new born, pregnant lady.Pre schoolar are responsible for about 50% of total caseIt is more common in females then males,`and single attack confers life long immunity.

118. ENVIORNMENTAL FACTORPertusis spread throughout year but more cases found in winter/spring season.Over crowding place.Low sanitation area.Poor environmental hygiene.Person with decreased immunity.Unimmunized persons against whooping cough.

9. PATHOGENESISCausative Agent(B- Pertusis)

Liberates numbers of antigen & toxins Pathological changes in the respiratory tract.(Nasophraynx to Bronchioles)

Inflammatory response to mucosa & secreation appear

Local epithelium damage & symptom appear

PERTUSIS DISEASE

10. CLINICAL MENIFESTATIONClinical menifestation include 3 stages;Catarrhal Stage (Pre paroxymal stage, 0-2 weeks)Paroxymal Stage (Spasmodic stage, 2-4 weeks)Convulscent Stage (Last 2 weeks)

STAGE-I CATARRHAL STAGE

Catarrhal symptoms appear that are:FeverRhinitisSneezingAnorexiaNausea & VomitingLacrimationIrritating cough at night (nocturnal but later become diurnal)

STAGE-II PAROXYMAL STAGECough means in paroxymus (repeatating) & is accompanied by vomiting.A typical attack consist of repeated series of many cough in expiration followed by sudden deep, violent inspiration with characterise crowing sound WHOOP .Ulcer of franulum of tounge.SweatingCongestion of neck & scalp vein.Patient appears suffocated with congested (red) face with or without cyanosis.Mouth opened, periorbital oedemaSub conjuctional haemorrhageConvulsion may be present.SUBCONJUCTIVAL HAEMORRHRGE

ULCER OF LINGUAL FRANULUM PERIORBITAL OEDEMA

STAGE-III CONVULSCENT STAGEDisturbing cough & vomiting stops and apatite too imprones.(start of hungerness)Habit pattern of coughing may be longer to several weeks & month.

11. COMPLICATIONSOtitis media is quite frequent.Respiratory complications are:Pneumonia (specially in infants)AtelectasisBronchictaxisEmphysemaNeurological complicationIntra cranial hage (Haemorrhage)Seizures (due to cerebral hypoxia)ParalysisHaemiplegiaEncephalopathy (Encephalitis) (Due to cerebral anoxia)

Rupture of diaphragm.Rectal prolapse, umblical & inguinal hernia over whelming strain of violent cough.Malnutrition due to vomiting.12. DIAGNOSTIC EVALUATIONPertusis is difficult to diagnose because coughing may be due to common cold, bronchitis or chest infection.For accurate diagnosis:-CBC (Lymphocytosis increased)Chest X-Ray (Perihilar infiltration, atelectasis, emphysema)ELISA (To detect IgM, IgG, IgA)Nasophrayngeal swab (Mainly in stage-I)PERIHILIAR INFILTRATION

13. PREVENTION & CONTROLActive immunization is best preventive measure for pertusis.DPT Vaccine = 0.5 ml. IM, 5 doseDPT 1st dose 6 weeksDPT 2nd dose 10 weeksDPT 3rd dose 14 weeksDPT 1st Booster 16-18 monthDPT 2nd Booster 5 Years

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ANTIBIOTICSErythromycinAzithromycinClarithromycin

ERYTHROMYCIN

AZITHROMYCIN

CLARITHROMYCIN

14. HEALTH EDUCATIONEmphasis should be placed on minimizing exposure to susceptible person, specially infant.Isolation & restriction of case, should be excluded from work, school, preschool & child care centers.Regular health check up.Educate pregnant women to keep distance to such cases.Active immunization.

15. CONCLUSIONSo by this project, we can say that pertusis or whooping cough is a disease of respiratory mucus membrane.It is a bacterial and contageous disease which mainly caused by Bordetella Pertusis.It mainly occur in 3-5 year old children.It can be prevented by active immunization.It is treated by DPT Vaccines and Antibiotics.

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