Bordetella pertussis: Control of whooping cough
| A | It is a strict human pathogen | |
| B |
It can be cultured from the patient during catarrhal stage |
|
| C |
It leads to invasion of the respiratory mucosa |
|
| D |
Infection can be prevented by a acellular vaccine |
The following are true for Bordetella pertussis, EXCEPT:
| A |
It is a strict human pathogen |
|
| B |
It can be cultured from the patient during catarrhal stage |
|
| C |
It leads to invasion of the respiratory mucosa |
|
| D |
Infection can be prevented by a acellular vaccine |
A 5-year old child developed seizures a few months ago. The seizures start with feeling of strange smell (burning rubber), continue with generalized contractions, and end with rhythmic spasms. Consciousness is lost during attacks and the child is confused afterwards. When the seizures started, the child was referred to a neurologist who prescribed phenytoin as the initial treatment. Now, the parents bring the child back for scheduled DTP immunization (diphtheria, tetanus, pertussis). Which of the following is the most appropriate next step in the management?
| A |
Immunization with DTP vaccine. |
|
| B |
Change medication to phenobarbital and DTP immunization |
|
| C |
Two weeks drug holiday and DTP immunization afterwards |
|
| D |
Deferral of DTP immunization |
Acellular pertusis vaccine contains-(
| A |
Pertactin, flagillary hemagglutinin, cytotoxin, endotoxin |
|
| B |
Pertactin, flagillary hemagglutinin, fimbriae, endotoxin |
|
| C |
Pertactin, cytotoxin, fimbriae, pertusis toxin |
|
| D |
Flagillary hemagglutinin, pertusis toxin, fimbriae |
Ans. is ‘d’ i.e., Flagillary hemagglutinin, pertussis toxin, fimbrial
. Acellular pertussis vaccines currently available from different manufactures should be considered as different and unique products because of the presence of one or more different components which are:
– Chemically or genetically detoxified pertussis toxin (PT toxoid).
– Filamentous hemagglutinin
– 69k Da outer membrane protein ( also known as pertactin).
– Fimbrial-2 and fimbrial-3 antigens.
| A | Ampicillin | |
| B |
Gentamicin |
|
| C |
Erythromycin |
|
| D |
Penicillin |
Ans. is ‘c’ i.e., Erythromycin
Treatment of pertussis
DOC —-> Macrolides (Erythromycin, Azithromycin, Clarithromycin)
Alternative —-> Cotrimoxazole
| A |
Erythromycin |
|
| B |
Ciprofloxacin |
|
| C |
Tetracycline |
|
| D |
Penicillin |
Ans. is ‘a’ i.e., Erythromycin
Control of whooping cough
Control of whooping cough requires :‑
* Management of cases and contacts
* Prevention by active immunization
– Cases: Erythromycin is the DOC. Alternatives are ampicillin, tetracyclin & septran.
– Contacts : Those who are exposed → 10 days erythromycin
| A | Hepatitis B | |
| B |
Rubella |
|
| C |
Pertussis |
|
| D |
Mumps |
Ans. is ‘c’ i.e., Pertussis
In may 1974, the WHO officially launched a global immunization programme, known as expanded programme of immunization (EPI) to protect all children of the word against six vaccine-preventable diseases by the year 2000.
Pertussis vaccine side effect
| A |
Local pain |
|
| B |
Excessive cry |
|
| C |
Fever |
|
| D |
All of above |
Ans. is ‘d’ i.e., All of the above
Pertussis vaccine
- Available as whole cell and acellular as DTPw and DTPa
- Primary immunisation at 6, 10, 14 weeks followed by booster dose 1’/2 year and 5 year.
- Whole cell causes more side effect than acellular
- Side effect-local pain, redness, fever, irritability, excessive cry because of cortical irritation.
Contraindication
- Progressive neurological disease (Relative)
- Immediate anaphylasix
- Encephalopathy
- Persistent Inconsable cry
- Hypotensive – hyporesponsive episode
