Bordetella Pertussis or Whooping Cough

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Whooping cough is a highly contagious and acute respiratory disease caused by an aerobic Gram negative encapsulated coco-bacillus bacterium, Bordetella pertussis. It is a strict human pathogen with no known animal or environmental reservoirs and an air-borne disease. On inhalation, Bordetella pertussis colonizes the ciliated cells of the bronchio-epithelium to cause disease characterised by; epithelial damage, hyper mucus secretion, pulmonary edema and paroxysmal coughing. It is often accompanied by pneumonia, otitis edema, seizures, post-tussive vomiting and encephalopathy (1). For the disease to occur, Bordetella pertussis evades the host immune system and is disseminate in the lower respiratory tract. Inhaled bacteria droplets then attach to the ciliated epithelial cells in the nasal-pharynx and trachea. It is at this point that Bordetella pertussis produces virulent factors that are classified into two; adhesins and toxins. Adhesins mediate bacterial attachment to the epithelial cells while toxins that mediate the host immune system. Adhesins include; filamentous haemagglutinin, fimbriae and pertactin while toxins include pertussis toxin, tracheal cytotoxin and adenylate cyclase toxin(1). To understand the role of these virulence factors in whooping cough disease, a mouse model has been used (2). Studies have shown pertactin, a 69kDa non fimbrial outer membrane protein, facilitates attachment of the bacteria to ciliated respiratory cells. Experiments conducted on humans to test the role of pertactin have shown no significant effect except with the results from Bassinet (4). Furthermore, filamentous haemagglutinin confers infection by attaching to the host cells in the lower respiratory tract. It is about 2nm wide, and 50n... ... middle of paper ... ...lonization by Bordetella pertussis and identification of an immuno-dominant lipoprotein. Infect Immun 72:3350–3358 10. Mielcarek N, Debrie AS, Raze D et al (2006) Attenuated Bordetella pertussis: new live vaccines for intranasal immunisation. Vac- cine 24 (Suppl 2):54–55 11. Flak TA, Goldman WE (1999) Signalling and cellular specificity of airway nitric oxide production in pertussis. Cell Microbiol 1:51–60 12. Amirthalingam G. Strategies to control pertussis in infants (2013) Arch Dis Child 98(7):552-5. http://dx.doi.org/10.1136/ archdischild-2012-302968. PMid:23698594 13. Campbell H., G. Amirthalingam, N. Andrews, N.K. Fry, R.C. George, T.G. Harrison et al. Accelerating control of pertussis in England and Wales Emerg Infect Dis, 18 (2012), pp. 38–4 14. http://www.hpa.org.uk/hpr/archives/2013/news1913.htm 15. http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=58100

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