Bordatella

Question 1

Describe the appearance of Bordatella organisms

Answer 1

Gram negative coccobacilli

Question 2

What is the primary/most important disease caused by Bordatella?

Answer 2

Pertussis/Whooping Cough

Question 3

What are the virulence factors of Bordatella?

Answer 3

LPS, 0 antigen, fimbriae, fimbrial hemagluttinin antigen, pertussis toxin, dermonecrotic toxin, tracheal cytotoxin, adenylate cyclase

Question 4

What is the 0 Antigen?

Answer 4

It is a cellular antigen that interacts with TLR-4 and is very inflammatory.

Question 5

What is the fimbrial hemagglutinin?

Answer 5

These are short filaments on the cell surface of Bordatella organisms that are involved in the adherence to mucosal surfaces. The are the major component of new acellular vaccines.

Question 6

What is the mechanism of the pertussis toxin?

Answer 6

It leads to increased levels of intracellular cAMP which inhibits monocyte and neutrophil activation and killing. It also causes lymphocytosis.

Question 7

What are the major components of the new acellular vaccine for bordatella?

Answer 7

The fimbrial hemagglutinin, the pertussis toxin, and the 0M protein.

Question 8

What is the mechanism of the tracheal cytotoxin of Bordatella?

Answer 8

It inhibits and kills ciliated cells, prevents them from beating and triggers inflammation in the trachea

Question 9

What is the virulence mechanism of adenylate cyclase

Answer 9

it increases levels of intracellular cAMP and inhibits monocyte and neutrophil activation/killing.

Question 10

Is Bordatella found as normal flora?

Answer 10

NO! There is no such thing as a carrier state. It is only found in humans with the disease.

Question 11

How is Bordatella transmitted?

Answer 11

From person to person via respiratory droplets.

Question 12

Who is most susceptible to a Bordatella infection?

Answer 12

newborns!

Question 13

Why are newborns most susceptible to a broadtail infection?

Answer 13

They have no maternal antibodies yet

Question 14

What are the two stages of Bordatella infection?

Answer 14

The catarrhal stage and the paroxysmal stage

Question 15

What are the symptoms in the Catarrhal stage?

Answer 15

Mild symptoms of an uncomplicated URT, sore throat, fever, runny nose.

Question 16

What is the pathogenesis of Bordatella infection in the Catarrhal stage?

Answer 16

The bacteria attach to ciliated epithelial cells via (FHA) of the nasopharynx, they spread to the trachea and bronchi (with possible life-threatening bronchopneumonia), then they inhibit ciliary function and proliferate on the bacterial surface. There is also inflammation with pertussis toxin production.

Question 17

In which of the two stages of the Bordatella infection is the individual infectious?

Answer 17

The catarrhal stage is highly infectious and persists for 10-14 days.

Question 18

What are the symptoms of the paroxysmal stage of Bordatella infection?

Answer 18

There is a progression to the classic ‘whooping’ cough with attacks of coughing lasting 1-2 min. May be associated with vomiting, severe facial congestion, and appearance of suffocation.

Question 19

What is the life-threatening problem of the paroxysmal stage of Bordatella infection?

Answer 19

The mucous can block the airway in infants which is life threatening.

Question 20

What are other complications of the paroxysmal stage of Bordatella infection?

Answer 20

Neuropathy, seizures, secondary infection of the ears, sinuses or lower respiratory tract

Question 21

What is the pathogenesis of the paroxysmal stage of Bordatella infection?

Answer 21

It is complex and involves anoxia from coughing as well as the neurological effect of the numerous bacterial toxins.

Question 22

How long does the paroxsymal stage last in Bordatella infection?

Answer 22

1-6 weeks

Question 23

Is the person still infectious in the paroxysmal stage of Bordatella infection?

Answer 23

Yes, but there is decreasing communicability.

Question 24

What is the best way to diagnose Bordatella Infection?

Answer 24

Perinasal nasopharyngeal swab with culture on special media, PCR, and direct fluorescent AB staining, as well as serology for IgM/IgA to pertussis toxin

Question 25

What is the treatment for Bordatella Pertussis?

Answer 25

Erythromycin and other macrolides

Question 26

What is the benefit of treatment in Bordatella pertussis? Besides saving their life?

Answer 26

It can shorten the period of communicability, and it may shorten the paroxysmal stage if given early enough.

Question 27

What is contained in the acellular DTaP vaccine?

Answer 27

Purified fimbrial hemagglutinin antigen + pertussis toxoid.

Question 28

What is the dose schedule of the DTaP vaccine?

Answer 28

5 doses at 2,4,6, 15-18 mos and 4-6 yo.

Question 29

What is the downside of the acellular DTaP vaccine?

Answer 29

There is decreased effectiveness after 5 years, which leads to increased diseases.

Question 30

What is the Tdap?

Answer 30

The new booster immunization!

Question 31

Who is the Tdap booster recommended for?

Answer 31

adults and adolescents age 10-64 yo, and pregnant women after their 20th week of pregnancy.

Question 32

What is the benefit of the Tdap vaccine?

Answer 32

It decreases the incidence of disease in children and adults, and also reduces the burden of colonization, especially in mothers who may infect infants.