Bordetella pertussisBordetella pertussis

http://www.hhmi.princeton.edu/sw/2002/psidelsk/Microlinks.htm

OutlineOutline

Bordetella PertussisBordetella Pertussis microbiology microbiologyWhooping Cough/Pertussis Whooping Cough/Pertussis VaccineVaccineCurrent problems with Current problems with B. pertussisB. pertussis

Bordetella pertussisBordetella pertussis Basics Basics

Aerobic, Gram negative coccobacillusAerobic, Gram negative coccobacillusAlcaligenaceae Alcaligenaceae FamilyFamilySpecific to HumansSpecific to HumansColonizes the respiratory tract Colonizes the respiratory tract

Whooping Cough (Pertussis)Whooping Cough (Pertussis)

http://microvet.arizona.edu/Courses/MIC420/lecture_notes/bordetella_pertussis/gram_pertussis.html

TransmissionTransmissionVery ContagiousVery ContagiousTransmission occurs via respiratory Transmission occurs via respiratory

dropletsdroplets

http://www.ratbags.com/rsoles/history/2000/12december.htmhttp://www.universityscience.ie/imgs/scientists/whoopingcough.gif

AdhesionsAdhesions

Filamentous hemagglutininFilamentous hemagglutininPertactinPertactinFimbriaeFimbriae

http://www.rivm.nl/infectieziektenbulletin/bul1306/kinkhoest.jpghttp://www.my-pharm.ac.jp/~yishibas/research/Pertussis1.jpg

ToxinsToxins

Pertussis ToxinPertussis ToxinAdenylate Cyclase ToxinAdenylate Cyclase ToxinTracheal cytotoxinTracheal cytotoxinDermonecrotic toxinDermonecrotic toxinHeat-labile toxinHeat-labile toxin

www.ibl.fr/u447/u447.htm

Whooping CoughWhooping Cough

Also known as PertussisAlso known as PertussisOutbreaks first described in the 16Outbreaks first described in the 16thth

CenturyCenturyMajor cause of childhood fatality prior to Major cause of childhood fatality prior to

vaccinationvaccination

paaap.org/immunize/ course/slide27.html

Clinical Features Clinical Features

Incubation period 4-21 daysIncubation period 4-21 days3 Stages3 Stages

11stst Stage- Catarrhal Stage 1-2 weeks Stage- Catarrhal Stage 1-2 weeks22ndnd Stage- Paroxysmal Stage 1-6 weeks Stage- Paroxysmal Stage 1-6 weeks33rdrd Stage- Covalescent Stage weeks-months Stage- Covalescent Stage weeks-months

http://www.cdc.gov/nip/publications/pertussis/chapter1.pdf

Pertussis InfectionPertussis Infection

gsbs.utmb.edu/ microbook/ch031.htm

DiagnosisDiagnosis

Isolation by cultureIsolation by culturePCRPCRDirect fluorescent antibodyDirect fluorescent antibodySerological testingSerological testing

http://medinfo.ufl.edu/year2/mmid/bms5300/images/d7053.jpg

TreatmentTreatment

Antibiotic therapyAntibiotic therapyErythromycinErythromycinAzithromycin and clarithromycinAzithromycin and clarithromycin

http://www.aboutthatbug.com/AboutThatBug/files/CCLIBRARYFILES/FILENAME/0000000032/033_lg.jpg http://www.vet.purdue.edu/bms/courses/lcme510/chmrx/macrohd.htm

Pertussis VaccinePertussis Vaccine

1st Pertussis vaccine- whole cell1st Pertussis vaccine- whole cellAcellular vaccine now usedAcellular vaccine now usedCombination vaccinesCombination vaccines

http://www.nfid.org/publications/clinicalupdates/pediatric/pertussis.html

http://www.tdh.state.tx.us/immunize/providers.htm

Strain VariationStrain Variation

B. pertussisB. pertussis population has changed population has changed significantly since vaccine introductionsignificantly since vaccine introductionAdaptation to vaccineAdaptation to vaccineAntigenic divergenceAntigenic divergence

Mooi et al., 2001

Vaccine problemsVaccine problems

Complications/SafetyComplications/SafetyMultiple administration Multiple administration Waning adolescent and adult immunityWaning adolescent and adult immunityStrain VariabilityStrain Variability

http://www.healthcareforhoosiers.com/Member/vaccineschedule.html

ConclusionsConclusions

Reemerging in adult and adolescent Reemerging in adult and adolescent populations as worldwide vaccination rates populations as worldwide vaccination rates increaseincreaseHigh vaccination rates not enoughHigh vaccination rates not enoughBetter vaccine development neededBetter vaccine development needed