Recommended
More Related Content
What's hot
What's hot (20)
Similar to Pertussis and Whooping Cough Explained
Similar to Pertussis and Whooping Cough Explained (20)
More from M.Josephin Dayana
More from M.Josephin Dayana (19)
Recently uploaded
Recently uploaded (20)
Pertussis and Whooping Cough Explained
- 2. INTRODUCTION Pertussis is also known as Whooping cough is highly contagious bacterial diseases mainly caused by Bordetella pertussis. Characterized by severe coughing spells, which sometimes end with Whooping sound when the person breathes in. Also known as 100 days cough Habit pattern of coughing may be longer or subsequent weeks and month i.e., Chinese call it 100 days cough
- 3. definition Pertussis (also known as whooping cough or 100- day cough) is a highly contagious bacterial disease which is caused by the bacterium Bordetella pertussis, It is an airborne disease which spreads easily through the coughs and sneezes of an infected person
- 4. etiology Bordetella Pertussis-is the cause of epidemic pertussis and the usual cause of sporadic pertussis. B.Parapertussis- is an occasional cause of sporadic pertussis that contributes significantly to 5% of the total cases of pertussis. B. Bronchiseptica
- 5. Epidemiology Spread occurs by direct contact or droplet infections during cough. 1922-1948--- leading causes of death Infants less than one year of age constitute 50-70% of diagnosed cases. Extremely contagious-attack rate 100% Age : 1-5 years Incubation period : 7-10 days Infectivity : first 4 weeks
- 6. Pathophysiology Bordetella Pertussis produce the biologically active substances Inflammation of the respiratory mucosa Patchy Necrosis Tenacious mucopurulent exudate Bronchiolar obstructions i.e.,Atelectasis,Bronchiestasis
- 7. symptoms
- 8. clinical features Stages of Pertussis Catarrhal Stage Paroxysmal Stage Convalescent Stage Duration: 1-2 Weeks Duration: Normally 1-6 Weeks but may be as long as10 Weeks Duration: Cough lessening usually over 2-3 Weeks Symptoms : URI including running nose,sneezing,fever and mild cough Very Contagious during this stage Symptoms : Worsening Cough, Post- tussive emesis and inspiratory whooping,Cyanosis,exhausti on, leucocytosis,lymphocytosis and decreased weight Symptoms : Symptoms may return or worsen, if patient develops a second respiratory infection when still in this stage.
- 9. catarrhal stage The term "catarrh" is derived from historic Middle English, meaning "to flow." That is, secretions from the nose and mucous membranes flow, causing nasal congestion and runny nose. Nonspecific features Nasal congestion Runny nose- Rhinorrhoea Mild fever Eye redness and excess eye watering Sneezing
- 10. paroxysmal stage The term "paroxysm" means a sudden, violent burst. The paroxysms or "fits" of coughing may... Start as a dry, intermittent, annoying cough that increases in intensity and frequency Occur at least once an hour Cause the child to turn red, blue, or purple cause the eyes to bulge and water excessively cause significant distress in the child vomiting after coughing
- 11. Convalescent stage Episodes of cough becomes less frequent Less severe Paroxysms of whooping disappear Young infants may develop louder coughing but typically the breathing difficulty improves
- 12. diagnostic evaluation A complete blood count may show a high lymphocyte count. If the neutrophil count is high and/or fever is present, then other types of infection should be considered. Absolute Lymphocytosis (15,000-100,000 cells/mm3 ) Fluorescent antibody staining A chest x-ray may be normal or show mild abnormalities. Bacterial culture of respiratory secretions is the best test. (Nasopharyngeal aspirate
- 13. management Limit the number of paroxysms Observe the severity of cough and provide assistance when necessary Maximize nutrition, rest, and recovery Pharmacologic therapy Antimicrobial agents and antibiotics can hasten the eradication of B pertussis and help prevent spread Erythromycin, clarithromycin, and azithromycin are the preferred agents for patients aged 1 month or older
- 14. Management contd.., Prevention through immunization remains the best defence in the fight against pertussis. CDC recommendations for vaccination are as follows: DTaP vaccine: Recommended at the ages of 2, 4, 6, and 15-18 months and at age 4-6 years; it is not recommended for children aged 7 years or older Tdap vaccine: Recommended for children aged 7-10 years who are not fully vaccinated; as a single dose for adolescents 11-18 years of age; for any adult 19 years of age or older; and for pregnant woman regardless of vaccination history, including repeat vaccinations in subsequent pregnancies
- 15. complications Complications Infants less than 6 months of age are at the highest risk for complications. These include: Apnoea Bronchopneumonia Atelectasis Emphysema Ear infections Pneumonia Seizures Encephalopathy (brain damage) Death (approximately 1% of infants less than 2 months of age
- 16. Complications contd.., Epistaxis Sub-conjunctival haemorrhage Intracranial Bleeding Rectal prolapse umbilical hernias Dehydration, Malnutrition Tetany
- 17. prevention Pertussis vaccine is part of DPT vaccine All household contacts should get Erythromycin for 14 days Close contacts < 7 yr should get booster If documented pertussis infection exempt from routine pertussis vaccination Hygiene-Cover your mouth and nose with a tissue when you cough or sneeze. Put your used tissue in the waste basket. Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue. Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand rub if soap and water are not available
- 20. introduction Also called polio, infantile paralysis. Poliomyelitis is a highly infectious disease caused by polio virus I, II, III. This is a disease of digestive tract but since it can cause paralysis and deformity
- 21. Epidemiological factors Usually attacks the children below 5 years. Infection increases in dirty, overcrowded place, where personal health is neglected. Polio virus remains in the throat secretions, stools of infected persons which can infect water, milk, food, & other substances.
- 22. mode of transmission Transmission- through faecal-oral contamination, or through droplets; flies play an important role in spreading the disease. Can occur more in rainy season
- 23. causes Caused by polio virus Colonizes in the gastrointestinal tract ( specifically) in intestine Spread through faecal-oral route, Oral-oral route, Intake of contaminated food/ water
- 24. TYPES OF POLIO POLIO Non Paralytic polio Paralytic Polio Post – Polio Syndrome
- 25. NON PARALYTIC POLIO Obortive polio Type of polio that does not lead to paralysis Symptoms that last up to 10 days Like, Sore throat,fever, headache,vomitting, fatigue,backache,stiffness,neck pain, muscle weakness or tenderness
- 26. paralytic polio Main symptoms are, loss of reflexes Severe muscle ache or weakness Loose limbs
- 27. post polio syndrome Disabling the signs and symptoms that affect some peoples years after having polio like- Progressive muscle/joint weakness pain Fatigue Breathing problems Swallowing problems Decreased tolerance of cold temperature
- 28. incubation period 7-14 days
- 30. Paralysis in Lower extremities Face oesophagus
- 31. warning signs of paralysis Muscular weakness Stiffness &pain in the neck Back and lower body body pain
- 32. pathophysiology Virus gets into the body by mouth Then moves to GI tract towards intestine Multiplies Passes into the blood Reaches the spinal cord Attacks the nerves Destruction of motor neurons of nervous stem Polio paralysis
- 33. diagnostic evaluation Physical examination Poliovirus can be detected in specimens from the throat, faeces (stool) culture test, occasionally cerebrospinal fluid (CSF) by isolating the virus in cell culture or by detecting the virus by polymerase chain reaction (PCR)
- 34. complication Permanent deformity paralysis Handicaps If respiratory muscles are paralysed, death can also occur
- 35. management Bed rest. Pain relievers. Hot moist packs to control muscle pain and spasms. Portable ventilators to help with breathing. Physical therapy exercises to prevent bone deformity and loss of muscle function. Splints or other devices to encourage good position, or alignment, of the spine and limbs.
- 36. vaccines Oral polio vaccine Inactivated polio vaccine
- 37. comparison Oral polio vaccine Inactivated polio vaccine Albert Sabin develop Sabin vaccine Jonas Salk develops Salk vaccine Live attenuated(weakened) virus Killed virus Administered by drops Administered by injection Highly successful Highly effective and safe Inexpensive Expensive Easy to administer Requires trained health care workers Provides humoral,mucosaland gut immunity Provides humoral immunity Prevents paralysis and prevents re- infection Prevents paralysis but does not prevent re-infection Dose=2 drops Dose=0.5 ml Storage= -150c-250c Storage=+20cto+80c
- 40. Introduction It is an acute viral infection characterized by a final stage with a maculopapular rash erupting successively over the neck , face, trunk, arms and legs accompanied by a high fever Its an infection of respiratory system, immune system and skin caused by a virus, specially a paramyxovirus. Also known as Morbillivirus or Rubella. Spreads through respiration(contact with fluid from infected person’s nose and mouth)and is highly contagious.
- 41. definition Measles is an acute highly contagious viral disease caused by the measles virus. it is characterized by fever,URT catarrhal inflamation,koplik’s spots and maculopapular. Measles is characterized by small red dots appearing on the surface of the skin, irritation of the eyes (especially on exposure to light), coughing, and a runny nose. About 12 days after first exposure, the fever, sneezing, and runny nose appear.
- 42. etiology Measles virus, the cause of measles, is an RNA virus of the genus Morbillivirus in the family paramyxoviridae Only one serotype is known
- 43. Mode of transmission MODE OF TRANSMISSION Droplet nuclei and droplet infection that occur directly from person to person Infective period is 4 days before and 4 days after the development of rashes
- 44. incubation period INCUBATION PERIOD: Incubation period is usually 10 days from exposure to onset of fever. However rashes may be manifested at about 14 days after exposure. induced measles infection by vaccination may exhibit short incubation period 7 days.
- 45. pathophysiology The essential lesions of mucus is found in the skin, conjunctivae and mucus membranes of the bronchi, nasopharynx and intestinal tract Serous exudative and proliferation of mononuclear cell and few polymorphonuclear cells occur around the capillaries Hyperplasia of lymphoid tissue reaction occurs in the sebaceous gland and follicles kopliks spot consist of serous exudate and proliferation of endothelial cells similar to those in the skin lesions
- 46. pathophysiology Inflammatory reaction of the buccal and pharyngeal mucosa Broncho pneumonia may occur from the secondary bacterial infection In fatal cases of encephalomyelitis, perivascular demyelination occurs in areas of the brain and spinal cord In subacute sclerosing pan encephalitis (SSPE) there may be degeneration of the cortex and white matter with intranuclear and intracytoplasmic inclusion bodies
- 47. CLINICAL FEATURES Clinical features of measles are manifested in three stages Prodromal or pre- eruptive stage Eruptive stage convalescent or post- measles stage
- 48. Prodromal or pre- eruptive stage Prodromal stage usually starts after 10 days of infection and lasts 3 to 5 days. 3Cs
- 49. Prodromal or pre- eruptive stage This stage is manifested with Fever Malaise Sneezing Nasal discharge Lymphadenopathy Vomiting and diarrhoea
- 50. Prodromal or pre- eruptive stage koplik spot looks like a small, bluish-white spot with a red background on the inside of the cheek.
- 51. Eruptive stage is characterized by a typical irregular dusky red macular or maculopapular rash which found behind the ears and face first, usually 3 to 5 days after the onset of the disease. Then it spreads to neck, trunk, limbs, palms and soles in next 3 to 4 days Fever usually rise again or regress gradually within 3 days. Anorexia, malaise and cervical lymphadenopathy may present. Fever and rash usually disappear in 4 to 5 days in the same order of appearance. There is fine shedding of superficial skin of face, trunk and limbs, leaving brownish discoloration which may persist for 2 months or more ERUPTIVE STAGE
- 52. CONVALESCENT OR POST- MEASLES STAGE Convalescent stage is the period of disappearance of constitutional symptoms, fever and rash. But usually the child remains sick for number of days and lost weight. There may be gradual deterioration into chronic illness due to bacterial or viral infections, nutritional and metabolic disturbances or other complications
- 53. diagnosticevaluation History collection Physical examination Complete blood count checkup White blood cell elevation CSF fluid collection test
- 54. treatment There is no anti viral therapy Treatment is entirely supportive Antipyretics for fever Bed rest vaccination
- 55. INTRAVENOUS FLUIDS (IV) 2. Medications to control fever & pain 3. Antibiotic to treat secondary infection from bacteria 4. Vit. A 5. GOOD nursing care: (INCLUDES) a. Isolation until 5th of rash b. kept on bed until fever & cough subsides c. provide dim light, clean eye lid, irrigate affected eye with saline d. encourage more fluid intake during fever. e. Increase humidity (for children) of the room to relieve cough f. Relieve itching of skin (for children) by tepid bath & soothing lotion g. Immune serum or gamma-globuline may be given to modify illness & reduce complication h. Antibacterial therapy given for treatment of complication (e.i. respiratory infection & gastroenteritis)
- 56. complication Otitis media Pneumonia Encephalitis Hemiplegia Death
- 57. vaccination The initial measles immunization usually as Measles, Mumps ,rubella (MMR) Vaccines is recommended at 12-15 month of age MMR Vaccines may be; Measles post exposure Outbreak prophylaxis as early as 6 month of age
- 58. post exposure prophylaxis Passive immunization with immune globulin is effective for prevention and attenuation of measles with in 6 days of exposure Younger than 12 month of age Pregnant women Should receive the immune globulin 0.25ml/kg intramuscularly as soon as the possible after exposure but within 5 days