PERTUSSIS in children (WHOOPING COUGH).ppt

pertussis

1. PERTUSSIS (WHOOPING
COUGH)
PRESENTED BY
O. MALIYAMA

2. SPECIFIC OBJECTIVES
•Define pertussis
•Explain the epidemiology of pertussis
•Explain diagnosis of pertussis
•Outline clinical manifestations of pertussis
•Explain management of pertussis
•Explain prevention of pertussis
•Outline complications

3. DEFINITION
•Pertussis is a highly contagious infection which
results in fits when coughing that usually end
in a prolonged high pitched, deeply in drawn
breath (the whoop).

4. Causative organism
•It is caused by Bacterium- Bordetella Pertussis

5. EPIDEMIOLOGY
Incubation period
•21 days
Mode of spread
•Through droplets of an infected person produced
by coughing and sneezing
Communicability
•Mostly transmitted from 7 days after the person
has been exposed to the germs until 3 weeks
after the start of coughing

6. EPIDEMIOLOGY CT...
Predisposing factors
•Lack of immunisation
•Overcrowding
•Poor nutrition

7. PATHOPHYSIOLOGY
•The bacteria damage the cells of the
respiratory tract
•The damage produces a clear, very sticky
mucus which blocks the lumen of the
bronchiole
•Children try to get rid of the mucus by
coughing

8. PATHOPHYSIOLOGY CT...
•The cough may last for many weeks or even
months
•The persistent cough and vomiting and
accompanying sticky mucus may prevent the
child from sucking well

9. DIAGNOSIS
•A cough illness lasting at least two weeks and
characterised by at least one of the following:
-Fits when coughing
-Inspiratory whoop or vomiting after coughing
without other apparent cause

10. DIAGNOSIS CT...
•Observe the child’s cough
•Culture of mucus from back of nose or throat

11. CLINICAL MANIFESTATIONS
•Symptoms of mild cold e.g. Sneezing, runny
noise, watery eyes, fever, mild cough
•Numerous bursts of rapid coughing. At the
end of these bursts the child takes in air with a
high pitched whoop
•The child may turn blue because of lack of
Oxygen during long bursts of coughing

12. CLINICAL MANIFESTATIONS CT...
•Vomiting and exhaustion often follow the
coughing fits which are particularly frequent
at night
•The coughing gradually becomes less intense
and stops in two to three weeks
•Production of large amounts of thick mucus
which may be swallowed by babies/children
or seen as large bubbles from the nose

13. CLINICAL MANIFESTATIONS CT...
•Difficulties in breathing
•Persistent cough after the coughing fits
subside
•Sticky secretions

14. MANAGEMENT
•Isolation
•Nurse patient in fowlers position
•Maintain good nutrition and hydration
•Provision of oxygen and suctioning of
secretions
•Avoid factors which provoke attacks of
coughing

15. MANAGEMENT
•Treat with Erythromycin 7.5-12.5 mg/kg body
weight 6 hourly
•Give enough fluids to prevent dehydration
•Encourage breastfeeding
•Maintain nutrition compromised by vomiting
and exhaustion after bouts of coughing
•Give phenobarbitone 5mg /kg /dose 12 hourly
(caution it sedates)

16. PREVENTION
•Immunisation from the age of 6 weeks
•Maintain cold chain of vaccines

17. COMPLICATIONS
•Encephalitis
•Aspiration pnuemonia
•Otitis media
•Malnutrition
•Mental retardation if inflammation of the
brain takes place
•Sub-conjuctival haemorrhages due to violence
of the cough

18. REFERENCES
•Ministry of Health (2002). Expanded
Programme on Immunisation. Malawi Field
Operational Manual. Lilongwe
•Vlok, M.E.(2005) Manual of Community
Nursing: Communicable Diseases Juta & Co
Ltd. Cape Town

19. The end
•Thank you