Pertusis

Pertusis

• 1.
  PertusisPertusis  Soumya RanjanParidaSoumya Ranjan Parida  Basic B.Sc. Nursing 4Basic B.Sc. Nursing 4thth yearyear  Sum Nursing CollegeSum Nursing College
• 2.
  IntroductionIntroduction Sydenham-1670Sydenham-1670 Agent-Bordetella PertusisAgent-Bordetella Pertusis((pleomorphic,fastidious,non-motile,gram–pleomorphic,fastidious,non-motile,gram – ve,coccobacili,grows best on B.G media)ve,coccobacili,grows best on B.G media) Pertusis like illnessesPertusis like illnesses B.parapertusisB.parapertusis B.bronchisepticaB.bronchiseptica MycoplasmaMycoplasma Adeno virus -1,2,3,5Adeno virus -1,2,3,5 R.S.VR.S.V Parainfluenza & influenza virusesParainfluenza & influenza viruses EnterovirusesEnteroviruses
• 3.
  EpidemiologyEpidemiology Endemic, epidemic every3-4 yearsEndemic, epidemic every 3-4 years Peak season-July - OctoberPeak season-July - October Strike rate-80-100 %Strike rate-80-100 % Host –Host –more serious in females, younger agemore serious in females, younger age(50-70% cases<1 yr with most deaths)(50-70% cases<1 yr with most deaths) Maternal abs.-not protectiveMaternal abs.-not protective immunity wanes –subclinicalimmunity wanes –subclinical Reservoir( asymptomatic carriers )Reservoir( asymptomatic carriers ) Spread airborne droplet , direct contactSpread airborne droplet , direct contact Infectivity-till cough stops /7 day erythromycinInfectivity-till cough stops /7 day erythromycin
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  PathogenesisPathogenesis Biologically active substancesproduced by B.pertusisBiologically active substances produced by B.pertusis FHA (filamentous hemagglutination factor)FHA (filamentous hemagglutination factor) LPF / PT / PertectinLPF / PT / Pertectin Adenyl cyclaseAdenyl cyclase DemonecretinDemonecretin Tracheal cytotoxinTracheal cytotoxin Endotoxin (not imp.)Endotoxin (not imp.) Attachment on resp.epi.- toxin - peribronchial congestion +Attachment on resp.epi.- toxin - peribronchial congestion + mucosal edema +infiltration of lympho.- patchy areas ofmucosal edema +infiltration of lympho.- patchy areas of atelectasis & hyperinflation- v/p mismatch-hypoxia,atelectasis & hyperinflation- v/p mismatch-hypoxia, secondary infectionsecondary infection
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  Clinical featuresClinical features IncubationIncubation– 6-20 days (mean 7 days)– 6-20 days (mean 7 days) Clinical stagesClinical stages Catrrhoeal -Catrrhoeal -1-2 weeks, low grade fever , rhinorrhoea ,mild cough1-2 weeks, low grade fever , rhinorrhoea ,mild cough Paroxysmal-Paroxysmal- 2-4 weeks, repitative bouts ,whoop ,post tussive emesis2-4 weeks, repitative bouts ,whoop ,post tussive emesis non life threatening bout-non life threatening bout- <45 sec.red color change,tachycardia /<45 sec.red color change,tachycardia / bradycardia not < 60 ,oxygen desaturation resolves spontaneouslybradycardia not < 60 ,oxygen desaturation resolves spontaneously ConvalescentConvalescent
• 6.
  DiagnosisDiagnosis Typical clinical pictureTypicalclinical picture-H/O contact,cough > 2 weeks-H/O contact,cough > 2 weeks whoop , posttussive emesiswhoop , posttussive emesis InvestigationsInvestigations TLC- lymphocytosisTLC- lymphocytosis ESR- decreasedESR- decreased Fluroscent stain of secretionsFluroscent stain of secretions CIEPCIEP ELISA- detects ab.FHA ,PT IgG-PT most specificELISA- detects ab.FHA ,PT IgG-PT most specific DNA probe ,PCR.DNA probe ,PCR.
• 7.
  DiagnosisDiagnosis Typical clinical pictureTypicalclinical picture-H/O contact,cough > 2 weeks-H/O contact,cough > 2 weeks whoop , posttussive emesiswhoop , posttussive emesis InvestigationsInvestigations TLC- lymphocytosisTLC- lymphocytosis ESR- decreasedESR- decreased Fluroscent stain of secretionsFluroscent stain of secretions CIEPCIEP ELISA- detects ab.FHA ,PT IgG-PT most specificELISA- detects ab.FHA ,PT IgG-PT most specific DNA probe ,PCR.DNA probe ,PCR.