Haemophilus pertussis (Whooping Cough)

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Microbiology in Italy[1]
Haemophilus pertussis[2]

Etiology/Bacteriology

Taxonomy

| Domain = Bacteria | Phylum = Proteobacteria | Class = Betaproteobacteria | Order = Burkholderiales | Family = Alcaligenaceae | Genus = Bordetella | species = pertussis

NCBI: Taxonomy Genome: [4]

Description

Pathogenesis

Transmission

Infectious dose, incubation, and colonization

Virulence factors

Clinical features

Infant with pertussis[3]

Diagnosis

The classical method for identifying pertussis is to culture a nasopharyngeal sample. Yet, this method is not preferred due to the disease’s nature to disappear early in its process [1]. It is difficult to get an early diagnosis in adults due to the fact that intense coughing could be a result of other factors such as asthma, smoking, GERD, and medical treatments. It is also difficult to detect in young children unless severe symptoms like coughing occurs before vaccination. The most useful test for a diagnosis of a Bordetella pertussis infection is bacterial DNA tests performed on a nasal swab or wash specimen [3]. Other methods include antigen detection by direct fluorescent antibody and PCR [1].

Diagnosis can also be done serologically through complement fixation, agglutination tests, toxin neutralization, and enzyme-linked immunosorbent assay. The last method being the most commonly used today [1].

Treatment

Apnoeic or cyanotic cases of infants under 6 months should be taken care of in hospitals. Any suspicion of symptoms of whooping cough should be a sign to excuse children from school and receive antibiotic treatments within 3 weeks of illness. Clarithromycin and azithromycin are the preferred antibiotics for babies from birth to 1 year old. Adults can also take these antibiotics. However, co-trimoxazole can be used if the individual who cannot tolerate macrolides. Pregnant women who already has the disease are treated with erythromycin to prevent transmission to infant. Spasms are treated with mild sedation, and cyanosis is treated with administration of oxygen. [2]

Prevention

The key to preventing pertussis is vaccination, in infants as well as teenagers and adults. Booster vaccinations were recommended by the Advisory Council on Immunization in 2006 to increase immunity. Pregnant women are also vaccinated a month before giving birth to decrease the chances of the infant getting infected [3]. Primary vaccinations today are presented as pertussis antigens contained in pentavalent childhood vaccine, administered as a “before preschool” immunization requirement [1].

Host Immune Response

References

  1. Oakley S, and Kilcoyne A. The whooping cough epidemic: prevention and treatment. Practice Nursing. 2012 Oct. 604-7
  2. Treatment of Whooping Cough. General Practice Notebook (online)
  3. Pluta R.M. Pertussis. JAMA. 2010 Aug. (online)
  4. Cherry J.D. and Mattoo S. Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due to Bordetella pertussis and Other Bordetella Subspecies. ASM. 2005 Apr. (online)