Pertussis overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Pertussis, also known as whooping cough, a highly contagious disease caused by the bacterium Bordetella pertussis; it derived its name from a characteristic severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop"; a similar, milder disease is caused by B. parapertussis.[1] Worldwide, there are 30–50 million pertussis cases and about 300,000 deaths per year.
Despite generally high coverage with the DTP and DTaP vaccines, pertussis is one of the leading causes of vaccine-preventable deaths world-wide. Most deaths occur in young infants who are either unvaccinated or incompletely vaccinated; three doses of the vaccine are necessary for complete protection against pertussis. Ninety percent of all cases occur in the developing world. However, in the winter of 2006, a New York school district suffered a large pertussis outbreak with thirteen plus students falling victim to the infection. Also in the fall of 2006, a pertussis outbreak struck New Trier High School, a public school in Winnetka, Illinois, with twenty-four high school students catching the disease. In response, the Cook County Department of Public Health provided vaccine, free of charge, to eligible students.
Historical Perspective
Pertussis was recognizably described as early as 1578 by Guillaume de Baillou (1538-1616), but earlier reports date back at least to the 12th century.[2] B. pertussis was isolated in pure culture in 1906 by Jules Bordet and Octave Gengou, who also developed the first serology and vaccine. The complete B. pertussis genome of 4,086,186 base pairs was sequenced in 2002.
Pathophysiology
Infection occurs through direct contact with the aerosolized mucus of infected persons, usually during coughing and sneezing. The bacterium adheres to the ciliated epithelium of the nasopharynx, and proliferates in the lower respiratory system. In a small number of cases, the bacteria may move further to the pulmonary alveoli, causing Bordatella pneumonia. The bacteria does not however cross the respiratory epithelium to the bloodstream, and therefore sepsis is not seen.
Causes
Pertussis is caused by Bordetella pertussis or Bordetella parapertussis, a gram-negative coccobacillus.
References
- ↑ Finger H, von Koenig CHW (1996). Bordetella–Clinical Manifestations. In: Barron's Medical Microbiology (Barron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
- ↑ Versteegh FGA, Schellekens JFP, Fleer A, Roord JJ. (2005). "Pertussis: a concise historical review including diagnosis, incidence, clinical manifestations and the role of treatment and vaccination in management". Rev Med Microbiol. 16 (3): 79–89.