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Explore the microbiology of Bordetella pertussis, the bacterium responsible for causing whooping cough (pertussis), its transmission, virulence factors including toxins and adhesions, clinical features, diagnosis methods, treatment options, pertussis vaccine development, strain variability, and current problems related to vaccination. Learn about the challenges faced in eradicating pertussis and the importance of developing improved vaccines.
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Bordetella pertussis http://www.hhmi.princeton.edu/sw/2002/psidelsk/Microlinks.htm
Outline • Bordetella Pertussis microbiology • Whooping Cough/Pertussis • Vaccine • Current problems with B. pertussis
Bordetellapertussis Basics • Aerobic, Gram negative coccobacillus • Specific to Humans • Colonizes the respiratory tract • Whooping Cough (Pertussis) http://microvet.arizona.edu/Courses/MIC420/lecture_notes/bordetella_pertussis/ gram_pertussis.html
Transmission • Very Contagious • Transmission occurs via respiratory droplets http://www.ratbags.com/rsoles/history/2000/12december.htm http://www.universityscience.ie/imgs/scientists/whoopingcough.gif
Virulence Steele, R.W. Pertussis: Is Eradication Achievable. Pediatric Annals. Aug 2004. 33(8):525-534
Adhesions • Filamentous hemagglutinin • Pertactin • Fimbriae http://www.rivm.nl/infectieziektenbulletin/bul1306/kinkhoest.jpg http://www.my-pharm.ac.jp/~yishibas/research/Pertussis1.jpg
Toxins • Pertussis Toxin • Adenylate Cyclase Toxin • Tracheal cytotoxin • Dermonecrotic toxin • Heat-labile toxin www.ibl.fr/u447/u447.htm
Pertussis Toxin • Colonizing factor and endotoxin • Cell bound and extracellular gsbs.utmb.edu/ microbook/ch031.htm www.med.sc.edu:85/ ghaffar/pertussis.jpg
AdenylateCyclase Toxin • Invasive toxin • Impairment of immune effector cells Babu et al., 2001
Whooping Cough • Also known as Pertussis • Outbreaks first described in the 16th Century • Major cause of childhood fatality prior to vaccination paaap.org/immunize/ course/slide27.html
Clinical Features • Incubation period 4-21 days • 3 Stages • 1st Stage- Catarrhal Stage 1-2 weeks • 2nd Stage- Paroxysmal Stage 1-6 weeks • 3rd Stage- Covalescent Stage weeks-months http://www.cdc.gov/nip/publications/pertussis/chapter1.pdf
Pertussis Infection gsbs.utmb.edu/ microbook/ch031.htm
Diagnosis • Isolation by culture • PCR • Direct fluorescent antibody • Serological testing http://medinfo.ufl.edu/year2/mmid/bms5300/images/d7053.jpg
Treatment • Antibiotic therapy • Erythromycin • Azithromycin 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 Vaccine • 1st Pertussis vaccine- whole cell • Acellular vaccine now used • Combination vaccines http://www.tdh.state.tx.us/immunize/providers.htm http://www.nfid.org/publications/clinicalupdates/pediatric/pertussis.html
Strain Variation • B. pertussis population has changed significantly since vaccine introduction • Adaptation to vaccine • Antigenic divergence Mooi et al., 2001
Vaccine problems • Complications/Safety • Multiple administration • Waning adolescent and adult immunity • Strain Variability http://www.healthcareforhoosiers.com/Member/vaccineschedule.html
Conclusions • Reemerging in adult and adolescent populations as worldwide vaccination rates increase • High vaccination rates not enough • Better vaccine development needed