Whooping cough: Pertussis

Whooping cough:
Pertussis
(Alder, 2013)
By Latisha Nasse LPN
&
Kristen Dieterle Lab Tech
What is it?
❖ Highly contagious
acute respiratory
disease
(Mosby 2006)
❖
Bordetella
pertussis
(Black,2008)
❖ Affects infants and
younger children
➢ Fatal to babies
>1yr
(CDC, 2014)
❖ Teens & adults are
susceptible(CDC, 2014)
➢ Mostly are the carriers
Taxonomy
Domain- Bacteria
Kingdom- Eubacteria
Phylum-Proteobacteria
Class- Betaproteobacteria
Order- Burkholderiales
Family- Alcaligenaceae
Genus- Bordetella (7 sp.)
Species- Pertussis
(Brenner, Krieg, Garrity, & Staley, 2005)
(Bacterial Pathogens, 2005)
Etymology
❖ Bordetella- Named after Jules Bordet
-isolated pertussis with Octave Gengou
(Brenner et al., 2005)
❖ Per- very, severe
Tussis- cough
Pertussis = very severe cough
(Brenner et al., 2005)
❖ Chinese call it the “cough of 100 days”
(Black, 2008)
(Jules Bordet Biographical, 1967)
History
❖
❖
❖
❖
1578- Earliest description- G. Baillou
1813- First complete clinical description- Robert Watt
1906- Jules bordet & Octave Gengou isolated organism
1940s- vaccine made of inactivated whole cell
suspension
❖ 1997- Acellular vaccine (Alder, 2013)
❖ 2003- Genome sequenced (Parkhill, et al., 2003)
➢ Strain: Tahoma I
➢ 4,086,186 base pairs & 3,816 genes
Parasitic and Pathogenic
❖ Require a human host
(Bergey & Holt, 1994)
❖ Nicotinamide, organic sulfur (cysteine), and
organic nitrogen (amino acids)
(Bergey & Holt, 1994)
Growth
❖ Fastidious
❖ Only found in the respiratory tract of humans (Brenner et al. 2005)
❖ Susceptible to compounds such as unsaturated fatty
acids and sulfides (Alder, 2013; Brenner et al., 2005)
❖ Can be grown on:
➢ Bordet Gengou medium (potato-glycerol-blood agar)
(Alder, 2013; Brenner et al., 2005)
➢ Charcoal horse blood agar (Brenner et al. 2005)
➢ Stainer-Sholte Broth (Brenner et al. 2005)
➢ Cyclodextrin Solid Medium (Brenner et al. 2005)
Morphology & Physiology
❖ Colonies- smooth, convex, pearly, glistening, &
surrounded by a zone of hemolysis without definite
periphery (Bergey & Holt, 1994)
❖ Does not form a pellicle (Bergey & Holt, 1994)
❖ Minute .2-.5 x .5- 1 Micrometer (Brenner et al., 2005)
❖ Non-motile (Brenner et al., 2005)
❖ Coccobacillus (Black, 2008)
❖ Gram negative (Alder, 2013)
❖ surrounded by a slime sheath composed of extruded
filaments or secreted blebs (Brenner et al., 2005)
Morphology & Physiology Cont’d
❖ Obligate aerobe (Brenner et al., 2005)
❖ Optimal temperature 35-37°C (Brenner et al., 2005)
❖ Reproduce by Lysis, not budding (Bergey & Holt, 1994)
❖ Negative for cysts (Bergey & Holt, 1994)
Morphology & Physiology Cont’d
❖ Litmus Milk- Alkaline (Bergey & Holt, 1994)
❖ Chemoorganotrophic (Bergey & Holt, 1994)
❖ Does not produce (Bergey & Holt, 1994)
➢ Nitrate reductase (lab)
➢ Urease
➢ Indole from tryptophan (Lab)
❖ Does Produce
➢ Oxidase (Bergey & Holt, 1994)
➢ Catalase (Brenner et al., 2005)
In The Body…
❖ Infected respiratory droplet is inhaled
❖ Does not invade tissues or enter the blood
❖ Pertussis colonizes on the
cilia in respiratory tract
➢ Pertactin
➢ filamentous hemagglutinin
(Black, 2008)
(Black, 2008)
(Khanacademymedicine, 2014)
(Khanacademymedicine, 2014)
❖ dermonecrotic toxincauses inflammation &
local necrosis (Todar, 2012)
(Todar, 2012)
In The Body…Cont’d
❖ Tracheal cytotoxin (TCT)
➢ kills cilial cells & neutrophils (Khanacademymedicine, 2014)
➢ stimulates release of cytokine IL-1 (Todar, 2012)
❖ Adenylate cyclase toxin (ACT) & Pertussis toxin (PT)
➢ Prevent barrier cells and macrophages from
signaling to other cells
➢ Prevent breakdown by macrophages
➢ Cause lymphocytosis (PT only) (Khanacademymedicine, 2014)
3 Stages
❖ Catarrhal
(Black, 2008)
1-2 weeks
➢ Highly contagious
❖ Paroxysmal
4-6 weeks
➢ Most intense stage
❖ Convalescent
Months up to 2yrs.
Stage I Catarrhal
❖
❖
❖
❖
❖
fever
runny nose
sneezing
mild dry cough
listlessness
❖
❖
❖
❖
❖
(Mosby, 2006)
irritability
anorexia
vomiting
apnea (infants)
cyanosis
Stage II Paroxysmal
❖ moist cough
❖ uncontrollable
rapid coughing
fits
❖ whooping sound
❖ vomiting
❖ dehydration
❖ electrolyte
imbalance
(CDC, 2014)
❖
❖
❖
❖
❖
❖
❖
http://youtu.be/JKUSKYdYo9w
facial redness
cyanosis
exhaustion
fractured ribs
fainting
weight loss
loss of bladder
control
Stage III Convolescents
❖ mild cough
❖ secondary infections
(Black, 2008)
Transmission
❖ inhaling respiratory
droplets from an
infected person
(CDC, 2014)
❖ one person can
infect up to 15
other people
(CDC, 2014)
http://www.superhomeremedies.com/images/sneezing_spreads_flu_virus_800x535_pd.jpg
Diagnosis
❖ nasopharyngeal
swab
❖ blood work
(Black, 2008)
(CDC, 2014)
http://t1.gstatic.com/images?q=tbn:ANd9GcS27OrKksEALMxOToOJ5HrWvmXb1JqK_tTj1NvFiGtS_WbygzTvAbtQYZW7
Treatment
❖ bed rest
❖ Antibiotics
❖ oxygen therapy
➢ Erythromycin
❖ fluid and
➢ Tetracycline
➢ Chloramphenicol
nutritional
➢ Clarithromycin
encouragement
➢ Azithromycin
(Mosby, 2006)
(CDC, 2014)
Prevention
❖
❖ cover cough
❖ wash hands
➢ childhood - DTaP
❖ dispose of
■ 2, 4, 6 months
■ booster @ 15-18 months
soiled articles
■ booster @ 4-6yrs
❖ public
■ last 5 years
education
➢ teens & adults - Tdap
Vaccinations
(CDC, 2014)
(Leifer,2007)
■ last 10 years
Pertussis in the news...
❖ 2014 California Epidemic
❖ By June 10th California department of public health
showed reports of 3,458 cases
❖ 800 reported in 3 week period
❖ 24% increase in reports from 2013 throughout the U.S.
❖ 23 fold increase in risk of getting sick if not vaccinated
❖ 225 deaths in U.S. from 2000-2012
➢ 221 were babies <3 months
➢ cocooning
(Crawford, 2014)
References
(2014, September 05). Retrieved November 12, 2014, from http://www.cdc.gov/pertussis/
Alder, R.P. (2013). Whooping cough. Magill’s Medical Guide (Online Edition)
Bacterial Pathogens. (2005, January 1). Retrieved from http://www.biomedcentral.com/14712180/5/19/figure/F2?highres=y
Black, J. G. (2008). Microbiology: Principles and explorations. Hoboken, NJ: J. Wiley & Sons.
Bergey, D. H., & Holt, J. G. (1994). Bergey's manual of determinative bacteriology. Baltimore: Williams
& Wilkins.
Brenner, D. J., Krieg, N. R., Garrity, G. M., & Staley, J. T. (2005). Bergey's manual of systematic
bacteriology. Volume Two, The proteobacteria. New York: Springer.
Burton, G. R., & Engelkirk, P. G. (1995). Microbiology for the health sciences. Philadelphia: Lippincott.
Crawford, C. (2014, June 25). Pertussis Is Latest Disease Outbreak Concern in United States.
Retrieved November 19, 2014, from http://www.aafp.org/news/health-of-the-public/20140625pertussis.
html
References cont...
Chin, J. (2000). Control of communicable diseases manual: An official report of the American Public Health Association.
Washington, DC: American Public Health Association.
Khanacademymedicine. (2014, October 22). Pertussis pathophysiology [video file]. Retrieved from http://www.youtube.
com/watch?vXLcyqs5vQHQ
Leifer, G. (2007). Introduction to maternity & pediatric nursing. St. Louis, MO: Mosby/Elsevier.
Jules Bordet - Biographical. (1967). Retrieved November 18, 2014, from http://www.nobelprize.
org/nobel_prizes/medicine/laureates/1919/bordet-bio.html
Mosby's dictionary of medicine, nursing & health professions. (2006). St. Louis, MO: Mosby Elsevier.
Parkhill, J., Sebaihia, M., Preston, A., Murphy, L. D., Thomson, N., Harris, D. E., ... Maskell, D. J. (2003, 12).
Comparative analysis of the genome sequences of Bordetella pertussis, Bordetella parapertussis and Bordetella
bronchiseptica. Nature Genetics, 35(1), 32-40. doi: 10.1038/ng1227
Todar, K. (2012). Bordetella pertussis and whooping cough. Retrieved November 19, 2014, from http:
//textbookofbacteriology.net/pertussis_2.html
Weston, J. (2012, May 9). Pertussis Panic. Retrieved November 19, 2014, from http://www.apenotmonkey.
com/2012/05/09/pertussis-panic/
Williams, M. E. (2005). Epidemics. Farmington Hills, MI: Greenhaven Press.
Questions?
(Weston, 2012)