BMS 503 - Pertussis

What pathogen causes whooping cough?

Bordatella pertussis

What are the 3 hypotheses for why whooping cough has been on the rise?

1. children are not being vaccinated on schedule

2. waning immunity in adults

3. New strains of Pertussis

What are the characteristics of Bordatella pertussis?

small, gram -, cocco-bacilli

How does Bordatella pertussis enter the body?

inhalation of contaminated respiratory droplets

How does Bordatella pertussis spread and multiply?

extracellular growth, spreads from nasopharynx to trachea, bronchi, and bronchioles

Bordatella pertussis produces what?

Thick polysaccharide and kills ciliated epithelial cells

How is Bordatella pertussis diagnosed?

nasopharyngeal swab onto media followed by Gram stain and sero-testing

How is Bordatella pertussis treated prevented?

Erythromycin or Trimethoprim-Sulfmethoxazole, vaccination

Bordatella pertussis is resistant to what?

penicillin

What are the four virulence factors Bordatella pertussis expresses?

Pertussis toxin (inhibits recruitment of immune cells), Adenylate cyclase toxins (inhibits cytokine release), filamentous hemaglutinin (protein filament that facilitates attachment of bacteria to epithelium), tracheal cytotoxin (peptidoglycan that binds ciliated epithelial cells)

What is the pathogenesis of Bordatella pertussis?

bacteria attached to epithelium using FHA and Ptx, bacteria release TCF, inhibits cilia movement, bacterial numbers rise and kill ciliated cells, sloughed dead cells thicken mucous and contribute to bacterial spread

After 7-10 day incubation, Bordatella pertussis progresses through what three stages?

catarrhal, paroxysmal, convalescent

What happens in the catarrhal stage?

common cold symptoms, highest number of bacteria are generated

What happens in the paroxysmal stage?

repetitive cough follow by inspiratory whoop (paroxysms), ends with vomiting and exhaustion

What happens during the convalescent stage?

paroxysms decrease in number and severity, secondary complications arise

If identified in the catarrhal stage, Bordatella pertussis can be treated with what?

Erythromycin or Trimethoprim-Sulfamethoxazole

If identified during the paroxysmal or convalescent stage, Bordatella pertussis can be treated with what?

supportive care

Who developed the first Bordatella pertussis vaccine and why?

Peark Kendrick and Grace Elderling - children were dying

What is the vaccine makeup of Bordatella pertussis?

acellular - does not contain whole bacteria, contains a mixture of purified antigens

What is the current day Bordatella pertussis vaccination?

DTap - Pertussis, Tetanus toxoid, and Diptheria toxoid given in childhood the every 10 years booster in adulthood

The DTaP vaccine is not considered as effective as what?

DPT vaccine used prior to 2001