Paediatric disease Pertusis and whooping cough class presentation

1. Submitted to: Submitted by:
Resp. Pawan Sir Miss Abhilasha Verma
B. Sc. Nsg. Part-III
(2011-2012)

4. 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’’’.

5. 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.

6. 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

7. Fig: Bordetella Pertusis

8. 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.

9. 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.

10. DROPLET INFECTION

12. 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.

13. 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.

14. 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

16. 10. CLINICAL MENIFESTATION
Clinical menifestation include ‘3’ stages;
1. Catarrhal Stage (Pre paroxymal stage, 0-2 weeks)
2. Paroxymal Stage (Spasmodic stage, 2-4 weeks)
3. Convulscent Stage (Last 2 weeks)

17. 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)

18. 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.

19. SUBCONJUCTIVAL HAEMORRHRGE

20. ULCER OF LINGUAL FRANULUM

21. PERIORBITAL OEDEMA

22. 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.

24. 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)

25. Rupture of diaphragm.
Rectal prolapse, umblical & inguinal hernia over
whelming strain of violent cough.
Malnutrition due to vomiting.

26. 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)

27. PERIHILIAR INFILTRATION

28. 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

32. ANTIBIOTICS
• Erythromycin
• Azithromycin
• Clarithromycin

33. ERYTHROMYCIN

34. AZITHROMYCIN

35. CLARITHROMYCIN

36. 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.

38. 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.