The 3-year-old sister of a newborn baby develops a cough diagnosed as pertussis by nasopharyngeal cu

Discussion in 'MRCPCH forum' started by samuel, Sep 13, 2014.

  1. samuel

    samuel New Member

    The 3-year-old sister of a newborn baby develops a cough diagnosed as pertussis by nasopharyngeal culture. The mother gives a history of having been immunized as a child. Which of the following is a correct statement regarding this clinical situation?
    a. The mother has no risk of acquiring the disease because she was immunized.
    b. Hyperimmune globulin is effective in protecting the infant.
    c. The risk to the infant depends on the immune status of the mother.
    d. Erythromycin should be administered to the infant.
    e. The 3-year-old sister should be immediately immunized with an additional
    dose of pertussis vaccine.
  2. samuel

    samuel New Member

    The ans is D
    Newborn infants exposed to pertussis are at considerable risk of being infected regardless of the immune status of the mother. In contrast to other childhood infectious. diseases, pertussis is not entirely prevented by transplacentally acquired anti-body. Hyperimmune globulin is ineffective and not recommended. Natural immunity conferred by infection is lifelong. Because immunity acquired by immunization declines with age, however, many adults who were immunized in infancy are susceptible to pertussis. The Tdap vaccine has been introduced specifically to address this waning immunity; now, instead of merely receiving a scheduled tetanus (and diphtheria) booster with Td, adults may receive the Tdap which includes a pertussis booster. Erythromycin achieves high concentrations in respiratory secretions and is effective in eliminating organisms from the respiratory tract of patients. In exposed, susceptible persons, erythromycin may be effective in preventing or lessening severity of the dis-ease if administered during the preparoxysmal stage. Immunization against pertussis is unnecessary if the patient has had culture-proven pertussis

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