PLENARY 3In CPH

“Communicable Diseases”

(Pertussis)

Submitted by: Solidum Diore M.

BSMD 2Y2-5

(January 21, 2013)

PERTUSSIS

BRIEF DESCRIPTION

Pertussis is an acute infection of the respiratory tract. It begins as an ordinary cold, which in a typical case becomes increasingly severe, and after the

second week is attended by paroxysms of cough ending in a characteristic whoop as the breath is drawn in.

Vomiting may follow spasm. Cough may last for several weeks and occasionally 2-3 months.

ETIOLOGIC/CAUSATIVE AGENT

Hemophilus Pertussis or; Bordet Gengou Bacillus or; Bordetella pertussis or; pertussis bacillus.

SOURCE OF INFECTION

Discharges from laryngeal and bronchial mucous membrane of infected persons.

MODE OF TRANSMISSION

Direct spread through respiratory and salivary contacts. Crowding and close association with patients facilitate spread.

SIGNS AND SYMPTOMS

Early symptoms can last for 1 to 2 weeks and usually include:

Runny nose

Low-grade fever (generally minimal throughout the course of the disease)

Mild, occasional cough

Apnea — a pause in breathing (in infants)

Because pertussis in its early stages appears to be nothing more than the common cold, it is often not suspected or diagnosed until the more severe symptoms appear. Infected people are most contagious up to about 2 weeks after the cough begins. Antibiotics may shorten the amount of time someone is contagious.

As the disease progresses, the traditional symptoms of pertussis appear and include:

Paroxysms (fits) of many, rapid coughs followed by a high-pitched "whoop"

Vomiting (throwing up)

Exhaustion (very tired) after coughing fits

PERIOD OF COMMUNICABILITY

In early catarrhal stage, paroxysmal cough confirms provisional clinical diagnosis 7 days after exposure to 3 weeks after onset of paroxysms.

The incubation period of pertussis is commonly 7–10 days, with a range of 4–21 days, and rarely may be as long as 42 days.

SUSCEPTIBILITY, RESISTANCE, AND OCCURRANCE

Susceptibility is general, predominantly a childhood disease. The incidence being highest under 7 years of age and mortality highest in infants, particularly

under 6 months of age. One attack confers definite and prolonged immunity. Second attack occasionally occurs. A very prevalent and common disease among children everywhere regardless of race, climate or

geographic location.

METHODS OF PREVENTION AND CONTROL

Routine DPT (Diphtheria Pertussis Tetanus) immunization of all infants which can be started at 1 ½ months of life and given at monthly intervals in 3 consecutive months. This constitutes the primary infections.

Booster dose is to be given at the age of 2 years and again at 4 to 5 years of age. The patient should be segregated until after 3 weeks from the appearance of paroxysmal cough. If started early enough, antibiotics such as erythromycin can make the symptoms go away more

quickly. Unfortunately, most patients are diagnosed too late, when antibiotics aren't very effective. However, the medicines can help reduce the patient's ability to spread the disease to others.

Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. Infants with severe cases should be hospitalized.

An oxygen tent with high humidity may be used. Fluids may be given through a vein if coughing spells are severe enough to

prevent the person from drinking enough fluids. Sedatives (medicines to make you sleepy) may be prescribed for young

children.

Cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used.

REFERENCES:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002528/ Pacifico, Pilar B., Venzon, Lydia M., Hernando, Juanita P., Liwanag, Leonora M., Buenviaje,

Angelina M., Lacson, Filomena S., Espinosa, Amelia, Cuevas, Frances Priscilla L., Borja, Vicente E., Mejia, Clarita S. 2007 Public Health Nursing in the Philippines. 10th Edition. Publications Committee, National League of Philippine Government Nurses, Incorporated.

A baby with Pertussis