Submitted to: Submitted by: Resp. Pawan Sir Miss Abhilasha
Verma B. Sc. Nsg. Part-III (2011-2012)
1. INTRODUCTION Pertussis, 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. DEFINITION Pertusis 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. AGENT Agent of pertusis are- I. Bordetella Pertusis(gm +ve,
rod shaped, non motile) II. Bordetella Parapertusis III.
Haemophillus Haemolyticus IV. Adeno Virus V. Bronchi Septica
Fig: Bordetella Pertusis
4. INCUBATION PERIOD The 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 Contact It 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 & SEX It 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 case It is more
common in females then males,`and single attack confers life long
immunity.
8. ENVIORNMENTAL FACTOR Pertusis 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. PATHOGENESIS Causative 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
STAGE-I CATARRHAL STAGE Catarrhal symptoms appear that are:
Fever Rhinitis Sneezing Anorexia Nausea & Vomiting Lacrimation
Irritating cough at night (nocturnal but later become diurnal)
STAGE-II PAROXYMAL STAGE Cough 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. Sweating Congestion of neck &
scalp vein. Patient appears suffocated with congested (red) face
with or without cyanosis. Mouth opened, periorbital oedema Sub
conjuctional haemorrhage Convulsion may be present.
SUBCONJUCTIVAL HAEMORRHRGE
ULCER OF LINGUAL FRANULUM
PERIORBITAL OEDEMA
STAGE-III CONVULSCENT STAGE Disturbing cough & vomiting
stops and apatite too imprones.(start of hungerness) Habit pattern
of coughing may be longer to several weeks & month.
11. COMPLICATIONS Otitis media is quite frequent. Respiratory
complications are: Pneumonia (specially in infants) Atelectasis
Bronchictaxis Emphysema Neurological complication Intra cranial
hage (Haemorrhage) Seizures (due to cerebral hypoxia) Paralysis
Haemiplegia Encephalopathy (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 EVALUATION Pertusis is difficult to diagnose
because coughing may be due to common cold, bronchitis or chest
infection. For accurate diagnosis:- 1. CBC (Lymphocytosis
increased) 2. Chest X-Ray (Perihilar infiltration, atelectasis,
emphysema) 3. ELISA (To detect IgM, IgG, IgA) 4. Nasophrayngeal
swab (Mainly in stage-I)
PERIHILIAR INFILTRATION
13. PREVENTION & CONTROL Active immunization is best
preventive measure for pertusis. DPT Vaccine = 0.5 ml. IM, 5 dose
DPT 1st dose 6 weeks DPT 2nd dose 10 weeks DPT 3rd dose 14 weeks
DPT 1st Booster 16-18 month DPT 2nd Booster 5 Years
14. HEALTH EDUCATION Emphasis 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. CONCLUSION So 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.