April Wellness Lecture USA Re-emerging diseases Pertussis edited.ppt

April Wellness Lecture USA Re-emerging diseases Pertussis edited.ppt

1. Re-emerging diseases:
Pertussis
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2. Disclosure
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3. Pertussis
Dr. Ira Hope Salonga-Militante
Chief, Health Services
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5. Objectives:
•To discuss pertussis as one of the emerging
diseases post pandemic.
•To understand how this would impact the
school-environment.
•To implement actions to prevent an outbreak in
the workplace.
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7. World Health Organization
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8. Philippine Data
1
st
quarter of 2024 (46 cases & 2
deaths) : 2,200% increase
Nov 2023 (622 cases): 1,495%
increase
2022 (39 cases)
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9. Pertussis Trend in Western Visayas
18 cases reported as pertussis
•Age range: 0-12 years old
•10 (56%) were from Iloilo Province
Outcome
•2 (11%) died
As of March 13, 2024
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10. Pertussis Trend in Western Visayas
Case Classification:
•1 or 11% : Confirmed Pertussisthru
PCR
•1 Probable
PertussisDeath
•2 (11%) were unvaccinated
As of March 13, 2024
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11. Pertussis Trend in Western Visayas
72% Paroxysms of cough
67% cough more than 2 weeks
39% : had at least 1 dose of pertussisscontaining
vaccine
28% Post-tussivevomiting
17% Inspiratorywhooping
As of March 13, 2024
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14. https://mb.com.ph/2024/4/4/western-visayas-records-89-whooping-cough-cases-in-3-
months
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15. Pertussis Profile
Fastidious bacteria are difficult to grow in the laboratory because they have specific nutritional
requirements and growth conditions. They often require specialized growth media or
conditions to support their growth. This can make it difficult to diagnose.
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•Small, fastidious, gram-negative coccobacilli
that colonize only ciliated epithelium
•Incubation period: 3-12 days
Etiology: Bordetellapertussis
•Underrecognizedamong adolescents and adults
•Neither natural disease nor vaccination provides
complete or lifelong immunity against pertussisre-
infection or disease
•Coughing adolescents and adults are the usual
sources of infection for infants and children
Epidemiology:

16. Virulence Factors
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19. Clinical Significance
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20. Clinical Manifestations
•DO NOT display the classical stages
Infants (less than 3 months)
•Shortened stages of pertussis
•Adults may described a sudden feeling of strangulation
followed by uninterrupted cough
•Feelings of suffocation
•Bursting headache
•Gasping breath without a WHOOP (Duration more than
21 days)
Adolescents and immunized children
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21. Clinical Manifestations
https://www.youtube.com/shorts/NlnzAfTJJn4
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22. Infected people are most contagious during the
catarrhal stage through the 3
rd
week after the
onset of paroxysms or until 5 days after start
of effective antibiotics
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25. Case Classification and Definition
•Cough lasting at least two weeks with one:
•Paroxysms (fits) coughing
•Inspiratorywhooping
•Post-tussivevomiting
•Without other apparent cause
Clinical case
•Meets clinical case but no laboratory confirmation
Clinically-confirmed case
•Meets clinical case, NOT laboratory confirmed and NOT
epidemiologically linked to a laboratory-confirmed case
Probable case
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26. Community based tests
CBC
•Leukocytosiswith absolute
lymphocytosis, thrombocytosis
Chest Xray
•Perihilarinfiltrates or edema,
variable atelectasis, consolidation
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27. DOH: Active case finding in schools,
day care and hospitals
•Active case finding (clustering of cases)
•Outbreaks in schools, days and hospitals
•Reporting within 24 hours and collection of specimen
Surveillance
•Contact tracing done
•Emphasize early treatment among infants less than 6
months with respiratory illness
Contact Management
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29. PDIR+ of DOH
Prevent
Cover nose
and wipes
Avoid
coughing
into hands
Proper
cough
etiquette
Vaccination
Isolation
Household
settings
Hand
hygiene
Health/ Facilities
Disinfection
Personal
Protective
equipment
Limit
contact
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30. Pharmacologic treatment
Azithromycin
•Drug of choice
Macrolide(less than 14 days old)
Antibiotics must be prescribed by a
licensed physician.
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31. Post-exposure prophylaxis
All asymptomatic household contacts
•Given within 21 days upon the onset of cough
•Exposure: 1 meter within 1 hour
High-risk individuals
•Infants below 12 months
•Pregnant women on their 3
rd
trimester
•Immunocompromised
•High probability of close contact with high-risk
individuals
•Exacerbation of Asthma
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32. Vaccination
The History of Pertussis
(Whooping Cough);
1906–2015: Facts,
Myths, and
Misconceptions
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33. What is the difference between whole
cell and acellularpertussisvaccine?
Whole cell:
reactongenicity
Combination of
purified
antigens
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Wholecell Vaccines Acellularvaccines
•slight risk of febrile seizures
•1990s –it was discontinues
•Pentahibvaccine
•Lower initial efficacy
•Faster waningof immunity
•Possible reduced impact on
transmission

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37. Managing the Risk of Infectious
Diseases in the Workplace
•All job activities and work environments where
workers may be exposed to infectious diseases
should be identified and documented. Special
attention should be paid to workers who
are at a higher risk of exposure, such as
healthcare workers, laboratory workers,
Conduct Hazard Identification
•Control measures should be put
in place to protect high-risk
workers. Control measures can
be engineering controls,
administrative controls, or the
use of personal protective
equipment.
Implement Control Measures
•reduce risk by mechanical means.
These include barriers and room
ventilation.
Engineering controls
•involve changes to work processes and procedures to reduce
exposure. These include hand washing, encouraging sick workers to
remain at home, educating and training workers on safe work
processes and procedures in relation to infectious diseases, and
encouraging all workers to get vaccinated.
Administrativ
e controls
•considered the last line of defenceand
should only be used either when other
controls
Personal
protective
equipment
(PPE)
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38. What Can Workers Do to Protect Themselves?
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Ensure that their vaccinations are up to date
Keep a record of their personal vaccinations
Report exposure incidents to their supervisors or managers
Seek immediate medical attention after an occupational exposure
Wear the appropriate personal protective equipment (PPE)
Follow safe work procedures (especially for hand washing)
Attend all education and training sessions

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