Bordetella Pertussis Infection – Symptoms and Treatment

Bordetella pertussis affects the respiratory system. It is the cause of Pertussis which is more commonly known as Whooping cough. Whooping cough is a highly contagious disease. It is called so because individuals suffering from this illness seem to produce a characteristic “whoop” sound during inspiration after a bout of the episodic cough. This sound however may not be produced in infants below the age of 6 months and in older children and adults. This gram negative bacillus belongs to the genus Bordetella. It was first identified in 1906 by Bordet and Gengou. It has a worldwide distribution. Cyclical outbreaks of whooping cough are seen every 3 to 5 years, which is in spite of widespread immunization. It can occur in all months and can affect all age groups. However it commonly affects preschool and school age children.

The Chinese called Pertussis “the 100 day cough” owing to the long clinical course of the illness. Bordetella Pertussis is known to produce a variety of toxins which is responsible for its pathogenesis. The most commonly known toxin is “Pertussis Toxin” which has varied biological effects. The bacillus mainly colonizes in the nasopharynx. It attaches itself to the ciliated epithelial cells, after which it multiplies and releases a variety of toxins which decreases the host defense as well as damages the local epithelium. The paroxysmal cough caused is most probably due to the accumulated secretions as a result of impaired movements of the cilia.

Incubation period of this organism in the human host is about 7 to 10 days.

Symptoms: The first stage is the catarrhal stage. It resembles an acute upper respiratory tract infection. Symptoms include running nose, sneezing, low grade fever and mild cough. This stage of Bordetella Pertussis infection lasts for a week or two, which is followed by a second stage, the paroxysmal phase. This stage may last for one to six weeks. Symptoms of this stage include severe bouts of episodic cough, repetitive bursts of 5 to 10 coughs often with a single expiration. Following the cough the patient appears exhausted as well as vomiting may be present. Every episode of cough is followed by a “whoop” sound, which is produced due to rapid inflow of air during inspiration against a closed glottis. During an episode of cough, there may be neck vein distension, cyanosis, bulging eyes and tongue protrusion. These episodes of cough occur over a frequency of 5 to 10 per day, and are usually worse at night. The final stage is the convalescent stage, during which the episodes of cough become less frequent and less intense. This stage may last for a month to 3 months.

Treatment: Administration of antibiotics early in the clinical course of the illness is found to be highly effective. Antibiotics like Erythromycin, Clarithromycin, and Azithromycin are most frequently used. Since Bordetella Pertussis is a highly contagious infection, there is a high risk of transmission to the household contacts, hence administration of antibiotics as a prophylactic to all those who have come in contact with the suffering individual is advisable.

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