Rediscovering Pertussis

Area of Science:

• * Infectious Diseases
• * Bacteriology
• * Immunology

Background:

• * Pertussis, caused by Bordetella pertussis, is a highly contagious respiratory infection with significant impact on infants.
• * B. pertussis utilizes multiple virulence factors for colonization and immune system interference, leading to persistent infections.
• * Despite being vaccine-preventable, pertussis incidence is increasing globally in vaccinated populations.

Purpose of the Study:

• * To review the current understanding of Bordetella pertussis pathogenesis and immune evasion mechanisms.
• * To discuss the resurgence of pertussis and factors contributing to its persistence.
• * To explore potential strategies for controlling pertussis, including vaccination and novel therapeutic targets.

Main Methods:

• * Literature review of epidemiological data on pertussis incidence and vaccine effectiveness.
• * Analysis of B. pertussis virulence factors and their role in colonization and immune modulation.
• * Discussion of current and proposed control strategies, including cocooning and maternal immunization.

Main Results:

• * Rising pertussis incidence reported worldwide, particularly in young infants requiring intensive care.
• * Current acellular pertussis (aP) vaccines offer protection for 6-8 years, necessitating booster immunizations.
• * Factors contributing to resurgence include waning herd immunity, suboptimal vaccine coverage, and bacterial genetic changes.

Conclusions:

• * Pertussis remains a critical public health concern, especially for unvaccinated or under-vaccinated infants.
• * Strategies like cocooning and maternal immunization are promising for reducing neonatal pertussis.
• * Further research into B. pertussis immune modulation is crucial for developing enhanced therapeutics and vaccines.