Pertusis

1. PertusisPertusis
 Soumya Ranjan ParidaSoumya 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 every 3-4 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

4. PathogenesisPathogenesis
Biologically active substances produced 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

5. 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 pictureTypical clinical 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 pictureTypical clinical 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.