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Pertussis: Microbiology, Disease, Treatment, and Prevention
Paul E Kilgore1, Abdulbaset M Salim2, Marcus J Zervos3
1Department of Pharmacy Practice, Eugene Applebaum Collage of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA paul.kilgore@wayne.edu.
Abstract:
Pertussis is a severe respiratory infection caused by Bordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution of B. pertussis strains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmit B. pertussis to younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding of B. pertussis pathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines.
Insights
Pertussis, a severe respiratory infection caused by Bordetella pertussis, is reemerging globally. Understanding its evolution, immunology, and atypical presentations is crucial for developing new diagnostics and vaccines.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Pertussis (whooping cough), caused by Bordetella pertussis, remains a significant global health concern with millions of cases and hundreds of thousands of deaths annually.
- Recent years have seen substantial pertussis outbreaks, prompting international focus on understanding the virulence and genetic evolution of B. pertussis strains.
- Pertussis is increasingly recognized in adolescents and adults, who can act as reservoirs and transmit the bacteria to vulnerable infants, highlighting the importance of immunity.
Purpose of the Study:
- To deepen the understanding of Bordetella pertussis pathogen virulence and genetic evolution.
- To investigate the role of innate, humoral, and cell-mediated immunity, including waning immunity, in pertussis.
- To address challenges in recognizing atypical pertussis presentations in neonates and adults, which can delay treatment.
Main Methods:
- Review of epidemiological data and scientific literature on pertussis.
- Analysis of bacterial pathogenesis and genetic evolution of Bordetella pertussis strains.
- Exploration of immunological factors, including waning immunity, in disease susceptibility and transmission.
Main Results:
- Pertussis outbreaks are increasing, with significant global impact.
- Adults and adolescents play a role in transmission due to waning immunity and atypical presentations.
- New molecular analysis tools are advancing the understanding of pertussis epidemiology and pathogenesis.
Conclusions:
- A comprehensive understanding of pertussis epidemiology, pathogenesis, and immunology is essential.
- Improved recognition of atypical presentations in all age groups is needed for timely treatment.
- Advances in research provide a foundation for developing next-generation diagnostics, therapeutics, and vaccines against pertussis.
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