Case Study #4 - A woman reports to the emergency room in January with her cyanotic (blue-colored) 10 month old child. The mother reports that the infant has had a runny nose, fever, and slight cough for a day and has had increasing trouble breathing. The child does not have a history of bronchial disease and was not premature. The mother also states that the infant's 5 year old brother is recovering from symptoms that resemble a cold. What is the presumptive diagnosis? Respiratory Syncytial Virus (RSV) Severe Acute Respiratory Syndrome (SARS) Pertussis (Whooping Cough) Respiratory Influenza
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These symptoms are common in many respiratory illnesses. However, the child's cyanotic (blue-colored) appearance indicates a lack of oxygen, which suggests a severe respiratory condition. The fact that the child's older brother recently had symptoms resembling a Show more…
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History: A 9-year-old girl presented with low-grade fever, sore throat, and malaise for two days. These symptoms developed 10 days after arriving at a summer camp operated by a religious group. Recently, she was noted to have a dry cough and difficulty breathing. Her parents then brought her to the emergency department. The family had emigrated from Ukraine one year before. The child's immunization status could not be determined. She had been otherwise healthy. Physical Examination: Temperature: 38.9°C Pulse: 140/minute Respirations: 45/minute Blood Pressure: 92/50 mmHg Physical Examination - The patient was in severe distress; respiratory stridor was present; exudative pharyngitis and bilateral cervical adenopathy ("bull neck") were noted. A yellowish, leathery, thick membrane extending to the uvula and soft palate was also seen (see Figure 1) Laboratory studies Hematocrit: 42% White Blood Cells: 18,400/µL Differential: 92% PMNs Platelets: 320,000/µL Serum Chemistries: BUN 30 mg/dL, creatinine 1.0 mg/dL, O2 saturation 84% Imaging Chest x-ray was normal.
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Pertussis (whooping cough) is caused by a bacterial infection, and symptoms include an intense cough that lasts for weeks, sometimes leading to pneumonia and death. A complete vaccination against pertussis requires five doses, completed by age $5 .$ A pertussis outbreak occurred in California in $2010,$ and a news article reported the following: "Among fully immunized kids, there were about 36 cases for every 10,000 children two to seven years old, compared to 245 out of every 10,000 kids aged eight to 12 " Propose an explanation for these data and a public health solution based on your explanation.
Pertussis (whooping cough) is caused by a bacterial infection, and symptoms include an intense cough that lasts for weeks, sometimes leading to pneumonia and death. A complete vaccination against pertussis requires five doses, completed by age $5 .$ A pertussis outbreak occurred in California in 2010 , and a news article reported the following: "Among fully immunized kids, there were about 36 cases for every 10,000 children two to seven years old, compared to 245 out of every 10,000 kids aged eight to twelve." Propose an explanation for these data and a public health solution based on your explanation.
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