Question

A young mother rushes her four month old infant to the hospital emergency department and reports her infant gasping for air due to an asthma attack. An ED nurse evaluates the infant and questions the mother. The infant is cyanotic, irritable and experiencing a paroxysmal cough. The infant’s temperature is taken and noted as 103.8°F. The mother reveals the infant has been experiencing a cough and congestion for two weeks or more. The infant was born at home and has not been seen by a family practitioner or pediatrician to date. The infant has been exposed to neighborhood children ill with a mild cough. Chest x-rays are taken and blood samples are analyzed. The laboratory results indicate a highly elevated leukocyte count. Pronounced pneumonia is evident in the radiograph. In your post address the following: •Explain (and justify) to the infant’s mother that this is not an asthma attack and identify the likely infectious agent. •Explain that this is a vaccine-preventable disease and explain how vaccines prevent disease. Discuss, with at least two of your classmates, reasons this mother chose not to get her child vaccinated and ways to effectively counter her motives with evidence and empathy.

Answer 1

Question-1:

Question-1: Explain (and justify) to the infant’s mother that this is not an asthma attack and identify the likely infectious agent.

Pertusis or whooping cough:

In the above case, eventhough infant patient gasping for air due to an asthma attack but infant characteristically having symptoms cyanotic, irritable and experiencing a "paroxysmal cough" along with pneumonia symptoms with fever 103.8°F (mild).

The mother reveals the infant has been experiencing a cough and congestion for two weeks or more. The infant was born at home and has not been seen by a family practitioner or pediatrician to date. The infant has been exposed to neighborhood children ill with a mild cough.

Thereby it can be concluded that the infectious agent is transmitted from neighbourhood children and induced paroxymal cough stage. Sothat it can be concluded that it is caused by an infectious agent and based on above symptoms it is pertusis or whooping cough as described below.

The etiological agent of whooping cough or pertusis is a gram negative aerobic pathogen namely bordetella pertussis. The toxins released by this bacterium include pertussis toxin, haemagglutinin, fimbria and cytotoxin. This is a motile bacterium that can only live in humans, means humans are their only hosts. Whooping cough is an infectious disease that spread through droplets, vaccination can effectively control the disease spread. When performing serology testing, it is crucial to for blood tests to induce anti-pertussis toxin IgG to the infactns who are below 5 years old and those who have been coughing more than 2 weeks.

Treatment: In children including infants and family --------------> pertusis vaccination

In adults ------------------------------->Macrolide antibiotics include erythromycin, azithromycin, or combination of trimethoprim/sulfamethoxazol.

Some time asthma, chorinc obstructuve pulmonary disorder also causes pertusis cough.

Question-2:

Explain that this is a vaccine-preventable disease and explain how vaccines prevent disease

Answer:

For chiildren below 5 years old, it is recommended to boost the immnue system with vaccine so that in his blood tests it can be found that a highly elevated leukocyte count to produce acquired pactive immunity to act against pathogen. Booster dose must be given. Aapative immune system is an acquired immunity system which contains a very specific complex mechanism to invade infectious agents. This can be done by the process of vaccinisation. It has both humoral and cell-mediated immunity components. Already infected infant Innate immune system is prerequisite to activate the adaptive immune system via a process T-cell, B-cell mediated called antigen presentation and this system acts as chemical barrier to foreign pathogens. This is an older primitive immunity defense system found in multicellular species.

Question-3: Discuss, with at least two of your classmates, reasons this mother chose not to get her child vaccinated and ways to effectively counter her motives with evidence and empathy.

Answer: Mother chose not get her child vaccinated as she is afraid it may produce adverse effects if infant is immunised. She is thinking that active booster dose of prophylactic vaccination may induce anaphylactic reactions by forming antigen-antibody complexes. Her suspicion to administer vaccine is that these vaccines are biological products obtained from animal sources thereby these may further induce any antigen and antibody cross reactions. Sothat she prefers to give her child with antibiocts at low dose according child weight.