PERTUSSIS Flashcards
Acute infection of the respiratory tract that usually begins
as an ordinary cold that becomes severe, & after the
second week is manifested by paroxysm of cough ending
w/ a characteristic whoop as the breath is drawn in.
pertussis
___ reported cases
___ estimated deaths (2008)
___ estimated DTP3 coverage
151, 074
89, 000
86%
Philippines 2018 cases - A total of ___ pertussis cases
were reported nationwide from January 1-March 3, 2018
41
*Philippines 2020 cases – ___, death 1 (DOH, 2021)
2021 cases – ___, death 0
32, 10
other name for pertussis
whooping cough
causative agents of pertussis
bordetella pertussis
bordetella parapertussis
mode of transmission
direct spread - resp and salivary contact
crowding and close association with pts
pathophysiology of pertussis
Spread occurs via aerosol droplets from coughs
Bacteria damage ciliated respiratory epithelium from nasopharynx to bronchioles
Mucopurulent sanguineous exudate forms in airways
Exudate blocks small airways, leading to atelectasis, cough, cyanosis, pneumonia
Transmission happens through close contact or respiratory secretions
incubation period of pertussis
5-10 days, max 21 days
catarrhal stage lasts
1-2 weeks
paroxysmal stage lasts
1-6 weeks
convalescent stage lasts
weeks to months
Characterized by:
* Coryza
* Low-grade fever
* Mild, occasional cough (which gradually
becomes more severe)
catarrhal stage
Characterized by:
* Paroxysms of numerous, rapid coughs due to difficulty expelling
thick mucus from the tracheobronchial tree
* Long inspiratory effort accompanied by a high-pitched “whoop”
at the end of the paroxysms
* Cyanosis
* Vomiting and exhaustion
paroxysmal
true or false - paroxysmal attacks Occur frequently at night, with an average of 15 attacks per 24
hours
true
Increase in frequency during the first 1-2 weeks, remain at the
same frequency for 2-3 weeks, and then gradually decrease
paroxysmal attacks
Characterized by:
* Gradual recovery
* Less persistent, paroxysmal coughs that disappear in
2-3 weeks
Paroxysms often recur with subsequent respiratory
infections for many months after the onset of pertussis
convalescent
how to dx pertussis
- PE
- sputum / nasopharyngeal culture
- antigen detection
- chest radiography
Obtain a culture specimen either by performing a deep
nasopharyngeal aspiration or by holding a ___ or ___ swab in the patient’s posterior nasopharynx for 30 seconds until the
patient coughs.
dacron
calcium alginate swab
Keep in mind that B. pertussis can grow within 3 to 4 days of infection,
but a sample is not considered negative until ___ days.
10
Droplet precautions, in addition to standard precautions, are
recommended for ___ days after antibiotic therapy is started or, if
antibiotics were not given, until ___ weeks after the onset of
paroxysmal coughing
5 days
3 weeks
tx or mgmt for pertussis
- Fluid & electrolyte replacement
- Provision of adequate nutrition
- Mild sedation
- Oxygen therapy
- Suctioning
- Antibiotics
- Mucolytics
**Do not give expectorants.
pertussis complications
▪Encephalopathy
▪Pneumonia
▪Seizures
▪Rib fractures (adolescents)
▪Bleeding in the conjunctiva
▪Death
prevention of pertussis
*Active immunization with DPT
*Isolation until after 3 wks. from appearance of paroxysmal
cough
*Cough etiquette
*Hand hygiene
