Bordetella pertussis

Bordetella Pertussis is a gram-negative coccobacillus that belongs to the genus Bordetella. First described in 1906 by Bordet and Genou, B.pertussis infection causes a highly contagious respiratory disease in humans, known as whooping cough or pertussis. The organism is thought to be transmitted from human to human via aerosol droplets but does not survive for long periods in the environment.

Pertussis infection is localised to the respiratory airway and usually gives rise to a period of general malaise followed by a period of coughing that is described as paroxysmal, which can last between 1- 6 weeks. In addition, reports suggest that infection may cause an increase in lymphocyte numbers and cause confusion and other neurological symptoms. These symptoms may be due to B.pertussis virulence factors (Hewlett, EL). Some known virulence factors include pertussis toxin, filamentous haemagglutinin, pertactin, adenylate cyclase toxin and tracheal cytotoxin. However, the precise mechanism of pathogenesis is still unknown and the relevance of these and other potential virulence factors is still to be determined (CDC)

Until the introduction of a successful vaccine in the 1940s, whooping cough was a common illness in young children worldwide and a major cause of childhood mortality. Subsequent widespread vaccination resulted in a significant decrease in the number of cases worldwide. However, in recent years the number of reported cases have been rising in the USA and other developed countries. In addition, cases of infection have also been reported in adolescents, young adults and infants that are too young to vaccinate. These reports raise concerns regarding the efficacy of the vaccine currently in use and the possibility of waning immunity in vaccinated individuals (Hartzell, JD).

Currently, diagnosis of infection is achieved using serological techniques and molecular subtyping. However, correct diagnosis is complicated by the fact that symptoms of B.pertussis resemble other respiratory diseases in the early stages, suggesting a need for more sensitive methods of detection and diagnosis.

References

  1. Hewlett, EL (2014). Pertussis Pathogenesis—What We Know and What We Don’t Know. J Infect Dis.209(7): 982–985.
  2. Centers for Disease Control and Prevention: Pertussis (whooping cough)
  3. Hartzell, JD and Blaylock, JM (2014). Whooping cough in 2014 and beyond: an update and review. Chest.146(1):205-214.

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