Bordetella pertussis: Control of whooping cough

Bordetella pertussis: Control of whooping cough

Q. 1

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

Q. 1

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

Ans. D

Explanation:

Whole cell vaccine was effective but had side effects.

 Acellular vaccines are purified preparations.
 Acellular pertussis vaccines contain inactivated pertussis toxin which may provide protection against disease but not prevention against infection.
It can create career form in adults which can affect the infants.

Immunization reduces disease but outbreaks continue
 
Ref: Textbook of Microbiology By Ananthanarayan and Panicker, 5th Edition, Page 314

Q. 2

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

Q. 2

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

Ans. D

Explanation:

This child has typical tonic-clonic (grand mal) seizures which start with aura. The usual killed, whole-bacterial pertussis vaccine can cause high fever and convulsions. Pertussis vaccination can complicate the already apparent abnormalities and their management. Consequently, deferral of diphtheria, tetanus, pertussis immunization is appropriate. Immunization with DTP or pertussis vaccine and drug holiday can seriously backfire. 

 

 

 

Ref: Ogle J.W., Anderson M.S. (2012). Chapter 42. Infections: Bacterial & Spirochetal. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. 

 


Q. 3

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

Q. 3

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. D

Explanation:

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.


Q. 4

The antibiotic of choice of pertussis is –

 A

Ampicillin

 B

Gentamicin

 C

Erythromycin

 D

Penicillin

Q. 4

The antibiotic of choice of pertussis is –

 A

Ampicillin

 B

Gentamicin

 C

Erythromycin

 D

Penicillin

Ans. C

Explanation:

Ans. is ‘c’ i.e., Erythromycin 

Treatment of pertussis

DOC                   —->      Macrolides (Erythromycin, Azithromycin, Clarithromycin)

Alternative            —->        Cotrimoxazole


Q. 5

In control of pertussis, the drug of choice for cases‑

 A

Erythromycin

 B

Ciprofloxacin

 C

Tetracycline

 D

Penicillin

Q. 5

In control of pertussis, the drug of choice for cases‑

 A

Erythromycin

 B

Ciprofloxacin

 C

Tetracycline

 D

Penicillin

Ans. A

Explanation:

Ans. is ‘a’ i.e., Erythromycin 

Control of whooping cough

o Control of whooping cough requires :‑

1)       Management of cases and contacts

2)       Prevention by active immunization

Cases: Erythromycin is the DOC. Alternatives are ampicillin, tetracyclin & septran.

Contacts : Those who are exposed —> 10 days erythromycin


Q. 6

Which of the following was a part of expanded programme of immunization ‑

 A

Hepatitis B

 B

Rubella

 C

Pertussis

 D

Mumps

Q. 6

Which of the following was a part of expanded programme of immunization ‑

 A

Hepatitis B

 B

Rubella

 C

Pertussis

 D

Mumps

Ans. C

Explanation:

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.


Q. 7

Pertussis vaccine side effect

 A

Local pain

 B

Excessive cry

 C

Fever

 D

All of above

Q. 7

Pertussis vaccine side effect

 A

Local pain

 B

Excessive cry

 C

Fever

 D

All of above

Ans. D

Explanation:

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

  1. Progressive neurological disease (Relative)
  2. Immediate anaphylasix
  3. Encephalopathy
  4. Persistent Inconsable cry
  5. Hypotensive – hyporesponsive episode


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