Bordetella

CASE 1

• A 3 year old boy has a severe cough that sometimes precipitates vomiting. His illness began 10 days ago with symptoms that suggested a cold -- low grade fever, runny nose, pink eyes, and mild cough. After about a week, the cough intensified, but the low grade fever resolved. The cough occurs in spasms, causing the child to become breathless and to take gasping deep breaths between spasms of coughing. Click on the link below to hear a sound recording with the characteristic "whooping" inspirations that are diagnostic of pertussis.

Characteristic cough

• These symptoms persisted for 2 weeks, and then slowly resolved, but the child was exhausted and weak for several more weeks.

• Antibiotic therapy was given when the child was initially evaluated, but they did not seem to affect the course of the illness.

Questions:

1. Is pertussis a kind of pneumonia (i.e., infection of the pulmonary airsacs)? If not, what is different about it?
2. Which cells are primarily damaged by the products of Bordetella pertussis?
3. What products does this bacterium make that facilitates its colonization of the airways and precipates the severe cough?
4. What simple blood test would be abnormal in a way that is highly characterisitic of pertussis?
5. If you wanted to try to isolate the organism, how would you go about doing it?
6. If antibiotic therapy does not shorten the illness, why was it given?
7. There is a vaccine against pertussis? What is it composed of? At what age should it be given to prevent the majority of cases?
8. Do adults acquire pertussis? What is their role in the propagation of the disease?