Bordatella

Question 1

what is another name for pertussis?

Answer 1

whooping cough

Question 2

bordatella causes what?

Answer 2

pertusis

Question 3

what are the 4 species of bordatella responsible for human disease?

Answer 3

1. Bordetella pertussis –
2. B. parapertussis
3. B.bronchoseptica
4. B.holmessi

Question 4

how common is pertussis in the US?

Answer 4

common

Question 5

what are the 2 vaccines for pertussis?

Answer 5

1) Tdap
2) DTaP

Question 6

who do you give Tdap vaccine?

Answer 6

for everyone 11 years and older, including pregnant women

Question 7

who do you give DTaP vaccine?

Answer 7

for children 2 months through 6 years of age

Question 8

Why then are there increasing cases & outbreaks of the disease in the US ?

Answer 8

• Immunity in vaccinated individuals wanes over time *
• Adults (vaccinated in childhood) can still contract disease (typically mild) – reservoir *
• Highly contagious – newborns and young infants (less than one year) get infected (severe disease/death) *

Question 9

what is the biology of bordatella pertussis?

Answer 9

Gram negative coccobaccilus, strict aerobe

Question 10

how does bordatella pertussis spread?

Answer 10

respiratory droptlets

Question 11

how contagious is bordatella pertussis?

Answer 11

highly contagious

Question 12

what part of the body does bordatella pertussis target?

Answer 12

Infects ciliated respiratory epithelium *

Question 13

where do we find bordatella pertussis reservoir?

Answer 13

Reservoir: infected humans with mild disease *

Question 14

who is at risk of acquiring bordatella pertussis?

Answer 14

Unvaccinated (children & adults) *

Question 15

who will get the worst of the disease?

Answer 15

unvaccinated infants

Question 16

what are the virulence factors for bordatella pertussis?

Answer 16

1. Filamentous hemagglutinin, pertactin, fimbriae

• Pertussis toxin helps
• Damage to respiratory mucosa:

2. Adenylate cyclase toxin

• Increase in cAMP  increased respiratory secretions
• Impairs leukocyte chemotaxis  inhibits phagocytosis

3. Tracheal cytotoxin

• Interferes with ciliary action, kills ciliated cells
• Inhibits regeneration of damaged cells
• Dermonecrotic toxin

4. PERTUSSIS TOXIN*
   * increase in resp. secretions

Question 17

what does the Pertussis toxin * promote?

Answer 17

lymphocytosis *

Question 18

what will the pertussis toxin inhibit?

Answer 18

Inhibits phagocytic killing

Question 19

the pertussis toxin will increase sensitivity to what?

Answer 19

Increased histamine sensitivity

Question 20

what are the 3 phases of pertussis infection?

Answer 20

1. Catarrhal phase (1-2 weeks)
2. Paroxysmal phase (1-6 weeks)
3. Convalescent phase

Question 21

what happens in the catarrhal phase?

Answer 21

sneezing, mild cough, low fever, runny nose

Question 22

what happens in the paroxysmal phase?

Answer 22

• Severe cough (5-20 forced hacking coughs followed by a “whooping” sound on inspiration)
• Apnea (pause in breathing) – in infants
• Anoxia and vomitting may occur

Question 23

what happens in the Convalescent phase?

Answer 23

cough fits gradually decrease in length and intensity

Question 24

what complications can pertussis lead to in infants and children?

Answer 24

• Pneumonia
• Apnea
• Convulsions
• Neurological damage (in infants might be permanent)
• 1-2% deaths (unvaccinated infants)

Question 25

what nasopharyngeal cultures can be used to confirm pertussis?

Answer 25

Bordet-Genou medium / Regan-Lowe medium *

Has charcoal added *

Question 26

what is the treatment for pertussis?

Answer 26

• Erythromycin
• TMP-SMX

Question 27

when should expecting mothers receive vaccines for pertussis?

Answer 27

(at 27-36 weeks) *