WHOOPING COUGH (PERTUSSIS) Whooping cough is a highly contagious disease, which is transmitted through air. It is highly communicable and nearly 90% of the susceptible individuals develop the disease. (Brenner et. al, 2005). Whooping Cough or Pertussis is caused by the bacteria, Bordetella pertussis…
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There are two types of pertussis: severe and mild. Severe pertussis occurs in the infants and young children. Severe pertussis is more complicated and may lead even to death, whereas, mild pertussis is hard to diagnose and it is mostly misunderstood for common cold. Bordetella pertussis was first isolated in pure culture in 1906 by Bordet and Gengou. B.pertussis is a small, gram –negative, aerobic coccobacillus of 0.8 ?m by 0.4 ?m. (Finger & von Koenig, 1996). It is arranged singly or in small groups. They also have pili-like filaments and are non-motile. B.pertussis is the most fastidious bacteria. It is transmitted from person – to – person through aerosolized droplets. (Baron, 1996) Figure 1 : Bordetella pertussis, the agent of pertussis or whooping cough. Gram stain. (CDC) (Todar, 2004) Pathogenicity B.pertussis causes respiratory tract infection in humans and warm blooded animals (Brenner et. al, 2005). The incubation period of this bacterium is 7-10 days. The bacterial cells “colonize only the ciliated cells of the respiratory mucosa.” (“Bacteria Genomes”). After the onset of the infection, the cells colonize in the mucosal membrane of the respiratory tract. The attachment of the B.pertussis occurs with the help of a pertussis toxin produced by the bacterium. The filaments those are present in the bacteria acts as a bridge between the bacterium and the ciliary receptor. Figure 2. Colonization of tracheal epithelial cells by Bordetella pertussis (Todar, 2004) This pertussis toxin is highly toxic and has a number of virulent factors. The adjuvant effect of pertussis toxin on the human body results in lymphocytosis and hypoglycemia within 3 hours in the ciliated epithelial cells and also causes ciliostasis. The adenylate cyclase toxin and tracheal cytotoxin combines with pertussis toxin to cause ciliostasis. The same toxins inhibit the phagocytic activities of the host. The phagocytic activities include chemo taxis, engulfment, the oxidative burst, and bactericidal killing. The adenylate cyclase is a hemolysin that causes lysis of the red blood cells. The tracheal cytotoxin stops the beating mechanism of the ciliated cells. This toxin then kills the ciliated cells and extrudes it from the mucosa. It also stimulates the release of the Interleukin – I, thus causing fever. (Baron, 1996 & Todar, 2004) Signs and Symptoms The first stage symptoms of pertussis are cough, low –grade fever, running nose, sneezing, etc. After 7 – 10 days, the nasal discharge gets thickened and the cough also gets severe. This leads to severe upper respiratory congestion in infants. This is the second stage. It lasts for 1-2 weeks. The third stage is the more complicated stage. The coughing increases very heavily that the child will cough more than 5 times during a single respiration and have a sudden intake of air, causing a whooping sound. The sound is caused due to the narrowed glottis. At this stage vomiting, weight loss, tongue protruding, eyes bulging are most common. Pneumonia, the serious complication of pertussis, results in the 90% of the deaths in children under the age of 3. The infection of the bacterium causes substantial immunity. This substantial immunity lasts for many years. The second infections are more frequent in adults and are usually not severe. The infants and children are highly prone to the lethality of this disease. The children who are suffering from whooping cough are prone to pneumonia. This
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