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The Virulent Factors Of Bordetella Pertusis: The Whooping Cough

885 words - 4 pages

Globally, whooping cough continues as an infection of public health concern despite the extensive vaccination and control strategies (Cherry J.D Heininger, 2004). The disease is alarmingly increasing in adolescents and adults, who consequently transmit it to infants. The increase has been attributed to: waning vaccine-induced immunity, increased recognition, changing in circulating strains, improved methods of surveillance and diagnosis of the illness. However, major public health concerns arise from this waning immunity as it is attributed to the increased whooping cough cases in adolescents and adults. Consequently, the adults and adolescents act as reservoirs for transmission to infants (Armirthalingam G, 2013 and Thomas et al., 2000).

In England and Wales, pertussis vaccination has been underway since 1957 with rising and falling trends in disease incidences over the years. But with the introduction of a more potent and less toxic acellular vaccine, the disease trend has changed. This vaccine has been used since in 2001, as a booster in the pre-school age group and has provided major protection in infants who are not eligible for vaccination (Armirthalingam et al., 2012). In addition, the accelerated schedule and high vaccine coverage has further lessened the general prevelance. However in April, 2012, there was a national outbreak majorly seen in adults and adolescents. This has led to new vaccination strategies such as: the temporary vaccination programme for expectant mothers as a way of protecting their unborn babies from the disease (Armirthalingam G, 2013).

Whooping cough is a highly contagious acute respiratory infection caused by an aerobic Gram negative non-sporulating encapsulated coco-bacillus bacterium, Bordetella pertussis. It is a strict human pathogen with no known animal or environmental reservoirs (Cotter and Miller, 2009) and transmitted through inhalation of bacteria-infected droplets. Consequently, the bacteria colonize the ciliated cells of the bronchio-epithelium causing whooping cough (Relman, D.A, 1995). Bordetella pertussis infection is characterised by mucus hyper-secretion, epithelial damage and pulmonary edema with symptoms: paroxysmal cough that last for close for a month and post-tussive vomiting. The illness is often accompanied by pneumonia, otitis edema, seizures and encephalopathy. For successful infection to occur, the bacterium should disseminate itself in the lower respiratory tract and evade the host's immune responses. Inhaled bacteria droplets attach onto the ciliated epithelial cells in the nasal-pharynx and trachea. At this point Bordetella pertussis produces many virulent factors to enable its survival in the host. These are classified basically into two: toxins and adhesins. Toxins include: Pertussis toxin (PT), tracheal cytotoxin (TCT), adenylate cyclase toxin (ACT) and lipooligosaccharide (LOS) while adhesins that mediate attachment onto the epithelial...

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