Means of transmission of Pertussis is direct contact with infected mucous droplets or airborne transmission of infected droplets. The only known reservoir is an infected human host. Carriers can also be asymptomatic.
The etiologic agent for Pertussis is Bordetella Pertussis. This agent is gram-negative coccobacilli. This encapsulated bacterium is non-motile, aerobic, and has fastidious growth requirements.1 A swab culture may be taken from the nose or mouth in order to diagnose Pertussis. Serological and immunological tests can also be used to test for Bordetella Pertussis.3
Jules Jean Baptiste Vincent Bordet and Octave Gengou were the first to discover the Bordetella Pertussis bacterium in 1906. Bordet and Gengou developed a vaccine and named the bacterium after its founder, Bordet, naming it Bordetella.4 Pertussis means a thorough cough.7 Pertussis is also referred to as whooping cough because of the noise person makes when coughing.5
Symptoms of pertussis are similar to those of the common cold (fever, runny nose, and cough). As the infection progresses, the cough turns into spasms. All together the infection lasts about six weeks.5 Difficulty breathing, choking, diarrhea, and vomiting are also symptoms of this disease.3 This disease is categorized into three stages: first is the catarrhal stage lasting from one to two weeks, second stage is the paroxysmal stage lasting two to six weeks, and the convalescent stage which lasts several weeks.1
Microbial virulence mechanisms' contributing to the disease process varies. Drug susceptibility includes erythromycin or TMP-SMX. This disease is very susceptible to a large variety of disinfectants. Dry or moist heat can inactivate this disease, but it is inactivated best by moist heat. Survival outside a reservoir can last one to two hours on surfaces, three to four hours in human sputum, nineteen to twenty hours in the air, three to five days on plastic, a day on paper and up to seven days in diluted saliva.1
Pertussis vaccine is given during infancy (DtaP) and boosters are given when needed. The DtaP vaccine does not insure immunity, therefore, sometimes antibiotics, like erythromycin is given when pertussis has been diagnosed. Cough syrups and/or suppressants are not recommended as treatments.3
Pertussis outbreaks occur every three to five years in the United States. The disease is an endemic, but can quickly develop into an epidemic. The last epidemic in the United States was in 1996. 2
The use of the cellular pertussis vaccine was stopped when reports indicated that the vaccine caused brain damage. A pertussis epidemic occurred, and unfortunately death followed. An acellular vaccine was produced and not like the cellular vaccine, the acellular contained proteins from the bacterium, not killed cells of the bacterium and has been used ever since.6
Challenges facing scientists include, learning the pathogenicity and immunity of pertussis and its effects on all ages, the diagnoses of pertussis and treatments, evaluation of vaccines and the threat of antibiotic resistance. 2
New opportunities that are involve in the research of pertussis include using different typing methods to reveal different virulence factors, analyzing antimicrobial susceptibility, and recognizing resistance factors.2
References:
1. Material Safety Data Sheet - Infectious Substances." Population and Public Health Branch. Date prepared: November 1999. Prepared by: Office of Laboratory Security, PPHB. Copyright (c) Health Canada, 2001. Last Updated: 2001-01-23. Date accessed: November 26, 2002. http://www.hc-sc.gc.ca/pphb-dgspsp/msds-ftss/msds20e.html
2. Pertussis." Centers for Disease Control and Prevention. Last Updated: July 2, 2002. Date accessed: November 26, 2002. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/pertussis_t.htm
3. Pertussis." Medical Encyclopedia. Last Updated: July 30,2002. Updated by: Jonathan Fanaroff, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network. Date accessed: December 6, 2002. http://www.nlm.nih.gov/medlineplus/ency/article/001561.htm
4. Who's Who in the Twentieth Century." Oxford University Press. Market House Books Ltd 1999. Content and Graphics copyright Oxford University Press, 2002. Last Updated: unavailable. Date accessed: November 26, 2002. http://www.xrefer.com/entry/170511
5. "Pertussis." The Iowa Clinic P.C. Last Updated: July 30, 2002. Reviewed By: Jonathan Fanaroff, M.D., Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH. Review provided by VeriMed Healthcare Network. Date accessed: November 26,2002. http://www.iowaclinic.com/adam/ency/article/001561.shtml
6. Chamberlain, Neal R. "No Long-Term Problems Associated With Two Vaccines: Microbiology." Suite101.com: Communities. Published on: August 31, 2001.Copyright (c) 1996-2002 Creative Marketeam Canada Ltd. doing business as Suite101.com. Last Updated: not available. Date accessed: December 3, 2002. http://www.suite101.com/article.cfm/microbiology/78811
7. Tortora, Funke, and Case. Microbiology, an Introduction. (7th Ed.) p.663.Pub. Daryl Fox. Printed: United States of America. Copyright 2001 by Benjamin Cummings, an imprint of Addison Wesley Longman, Inc.