BACTERIOLOGY
Whooping cough, the resurgence of a vaccine preventable disease
Dr Neil Bentley looks at the history, causes and treatment of whooping cough, as well as examining the vaccine issues which may have contributed to a recent resurgence of the condition in many countries around the world.
Pertussis disease, otherwise referred to as whooping cough or the ‘100-day cough’ is caused by members of the Bordetella spp. There are currently 16 members of the species and 12 that have been known to cause human infection: B. pertussis,
B. parapertussis, B. bronchiseptica, B. avium, B. hinzii, B. holmesii, B. trematum, B. ansorpii, B. petrii, B. broncialis, B. flabilis, and B. sputigena. Of these, B. pertussis and B. parapertussis are known to be the causative organisms of whooping cough,
with the latter causing a milder form of the disease.1
These bacteria are small
aerobic Gram-negative coccobacilli usually seen singularly or in pairs on Gram staining.2
They are transmitted via
airborne droplets, are highly contagious and considered more transmissible than SARS-CoV-2.3
Incubation periods
are usually around 7-10 days but can be as much as 20 days, and the patient remains infectious for up to five weeks.1 Diagnosis is often difficult as pertussis disease is initially not unlike common viral upper respiratory tract infections (URT) and sometimes can present atypically.4
fastidious, slow growing and requires specialist selective media.2
Moreover, the organism is Bordetella
spp. are hazard group 2 organisms;5 however, with clinical samples coming from the lower respiratory tract Mycobacterium tuberculosis, a hazard group 3 organism needs to be considered.
History There have been a number of different names associated with pertussis disease including those from the Anglo-Saxon word ‘hwostana’ meaning cough,6 through ‘chincough’,7
used term whooping cough4
to the commonly and more
Whooping cough diagnosis is often difficult as pertussis disease is initially not unlike common viral upper respiratory tract infections (URT) and sometimes can present atypically.
40
recently to 100-day cough as frequently used by the press.8 There are phylogenetic suggestions that these bacteria may date back 2.5 million years to the evolution of the human species.9
However, the first SEPTEMBER 2024
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