Pertussis Flashcards
what is the pathogen in whooping cough?
bordetella pertussis
bacteria
what is the main symptom of pertussis?
violent coughing spells
what is the cause of the whooping cough sound?
swollen airways
is bordetella pertussis gram negative or positive?
gram negative
how is pertussis transmitted? (2 ways)
1) airborne droplets
2) touch infected surface like doorknob (can survive for days)
how does pertussis attach to the epithelial cells?
it releases toxins that help the bacteria to anchor
what do certain pertussis toxins do to the cilia of epithelial cells? what is the consequence?
paralyzes cilia -> mucus builds up -> trigges violent cough reflex
what does pertussis toxin do to T cells?
proliferate, and blocks them from entering the tissue
what does pertussis toxin do to histamine?
make vessels and tissue more sensitive to histamine -> swelling of airway
how long is the incubation period of pertussis?
1 week
what happens during incubation period of pertussis?
bacteria are in the respiratory system, but haven’t multiplied enough to create damage
which phase comes after the incubation phase? what are the symptoms?
catarrhal phase: cough, nasal congestion, low-grade fever
(during this phase bacteria have multiplied and damaged the respiratory tract)
how long does the catarrhal phase last?
2 weeks
during which phase is a patient the most contagious?
catarrhal phase
what comes after the catarrhal phase?
paroxysmal phase
how long does the paroxysmal phase take?
1-6 weeks
what causes the symptoms during the paroxysmal phase?
the damage already done by bacteria
what is the main symptoms during the paroxysmal phase?
uninterrupted fit of coughing with a whooping sound
which part of the airway is swollen that causes the whooping sound?
the glottis (part of the larynx that contains the vocal cords)
what are accompanying symptoms during the paroxysmal phase?
vomiting, collapsed lung, broken rib, petechiae in face
what are accompanying symptoms during the paroxysmal phase, specifically for children? (5 things)
- gasping
- cyanosis
- apnea
- apparent life threatening events
- decreased O2 levels
what can be the result of decreased O2 levels in children with pertussis?
- seizures
- encephalopathy
- death
- increased risk of pneumonia
what comes after the paroxysmal phase?
convalescent phase
how long does the convalescent phase last?
2-3 weeks
what happens during the convalescent phase
coughing improves, whooping fades away, airway heals
when is it best to diagnose pertussis? why?
during catarrhal phase -> use antibiotics to kill bacteria and reduce damage
how to diagnose pertussis? (2 ways)
nasopharynx swab -> identify bacteria in culture
serology (detectable after few weeks)
through which lab outcome can you specifically determine the severity of pertussis? (especially in children)
degree of lymphocytosis
is there a vaccine for pertussis?
yes (in NL in DKTP = difterie kinkhoest tetanus polio)
how effective is the vaccine for pertussis?
> 90%
where do you see outbreaks of pertussis? (3)
- countries with low access to vaccines
- unvaccinated communities
- elderly (less ab’s -> boosters needed)
how to treat pertussis?
antibiotics (macrolides like azitromycin)
how to prevent transmission? (2)
(outside vaccination)
isolate patient, give ab prophylaxis to household contacts
when to vaccinate pregnant women? why?
in 3rd trimester -> mother creates ab’s that get passed through placenta and provide baby with passive immunity for months after birth
what are the 3 phases of pertussis?
- catarrhal phase: cough, contagious (2 wks)
- paroxysmal phase: whooping (1-6 wks)
- convalescent phase: improves (2-3wks)
