Pertussis: Bordetella pertussis

Question 1

Pertussis: Bordetella pertussis

Characteristics

Answer 1

Gram negative coccobacillus

Aerobic

Question 2

Pertussis: Bordetella pertussis

Virulence factors

Answer 2

1. Attachment: bind to ciliated epithelial cells
   a) Pertactin
   b) Filamentous hemagglutinin
2. Tissue Damage:
   a) pertussis toxin
   • ADP ribosylating activity of G proteins, cAMP, resp. mucus
   b) tracheal cytotoxin
   • Affinity for cilia
   • Causes ciliostasis or death of cells
   • Leads to characteristic cough
   • Stimulates IL-1 resulting in fever

Question 3

Pertussis: Bordetella pertussis``

Modes of transmission

Answer 3

Exposure: aerosol droplet inhalation

Human reservoir

Question 4

Pertussis: Bordetella pertussis

Symptoms

Answer 4

1. Catarrhal: coldlike symptoms, runny nose, sneezing, malaise, low fever, loss of appetite
   a) Highly transmissible, large # of bacteria
2. Paroxysmal: damage ciliated cells, impaired mucus clearance
   a) prolonged coughing fits with inspiratory whoop, 40-50/day, vomiting exhaustion, ruptured blood vessels in the eyes
3. Convalescence: recovery

Question 5

Pertussis: Bordetella pertussis

Potential complications

Answer 5

Whooping cough

Question 6

Pertussis Diagnosis

Answer 6

Nasopharyngeal aspirate best
Classic: Bordet-Gengou medium

Current: Regan-Lowe agar
Inoculate at bedside
7-12 days incubation

PCR – best if available

Question 7

Phase when cough begins

Answer 7

Paroxysmal

Question 8

Is there a Vaccine?

Answer 8

Acellular vaccine replaced whole cell inactivated vaccine