Whooping cough is a highly contagious disease caused by pertussis bacteria and may lead to death, particularly in infants less than 12 months of age. Whooping cough is preventable but Although it can be prevented by routine vaccination, it still affects many people, it can have serious complications including death. Management is only supportive. The majority need to be vaccinated to help protect those too young to be vaccinated.

1. 1
Erbil Polytechnic University
Shaqlawa Technical College
Medical Laboratory Department
Microbiology (Theory)
Second Stage (Third Semester)
Pertussis (whooping cough)
Prepared by :
Radwan Rushdi Mohammed
Supervised by: Assist. Prof. Dr. Zuber I. Hassan
2022-2021

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Contents
Pertussis (Whooping Cough) 3
Causative Agent of Pertussis 3
Pertussis Toxin 4
Symptoms of Pertussis 4
Diagnosing of Pertussis 5
Treatments used for Pertussis 6
Prevention from Pertussis 6
Conclusion 7
References 7

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Pertussis (Whooping cough)
Pertussis, also known as whooping cough, is caused by the Gram-negative bacterium
Bordetella pertussis. It is transmitted via airborne droplets and is highly infectious.
Pertussis sometimes mimics the presentation of a viral upper respiratory tract infection,
sometimes presenting atypically. After 4-21 days from the time of exposure, patients
present with symptoms of an upper respiratory tract infection such as coryza, low grade
fever. This is followed by the classic signs of pertussis, cough paroxysms, followed by
characteristic inspiratory whoop and vomiting that can last for up to 10 weeks, followed
by recovery. Coughing may be mild or severe. The illness can last up to three months and
is colloquially called "whooping cough.". A lot of patients develop symptoms that are out
of the ordinary for this disease, such as a shortness of breath, wheezing, fever, hot flashes,
and trouble breathing in children, and diarrhea and breastfeeding difficulties in infants.
Babies are at high risk of dying from lung infections hypertension and the resulting heart
failure and shock. Children are prone to dehydration and anorexia. Acute Cough-related
complications include pneumothorax, aspiration, urinary incontinence increases the risk of
rib fractures, especially the elderly. The patient may suffer from sinusitis, secondary
bacterial pneumonia and otitis media. Parents may worry about the risk of asthma and other
respiratory diseases Infections in children with a history of whooping cough [1+3]
Causative agent of Pertussis
Bordetella pertussis is a Gram-negative, aerobic, pathogenic, encapsulated coccobacillus
of the genus Bordetella and the causative agent of whooping cough B. pertussis is motile
and has a flagellum-like structure. It has many virulence factors including pertussis toxin,
adenylate cyclase toxin, filamentous hemagglutinin, pertactin, fimbria, and tracheal
cytotoxin. The bacterium is spread by airborne droplets and has an average incubation
period of 7–10 days. Humans are the only known host of B. pertussis infection. The genome
size of the disease organism is greatly reduced. This is mainly due to the adaptation to one
host species (human) and the loss of capability of survival outside of a host body. [4]

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Pertussis Toxin
Pertussis toxin (PTX) is a key toxin produced by B. pertussis to modulate immune
responses that promote invasion and evasion of immunity. PTX is a 105 kDa oligomer
composed of 6 subunits (named S1-5, with two copies of S4), making it one of the most
difficult identified bacterial toxins. The subunits are organized into an AB structure, with
S1 comprising the enzymatic A domain and the S2-5 subunits comprising the B domain
in the pentameric ring. [5]
Symptoms of Pertussis
Whooping cough usually starts with cold symptoms, such as a runny nose and stuffy nose.
You may also have a slight fever or cough. After 1 or 2 weeks, your cough will get worse.
Many children cough violently and quickly, with whooping cough sounds. They may
nausea with mucus and vomit after coughing. Not every child people with whooping cough
will make a whooping cough sound when they cough.
Early symptoms (first 1-2 weeks) - mostly "cold" symptoms
• Slight cough.
• Runny nose.
• fever (low grade and not seen in all people)
Later symptoms (between 2-12 weeks)
• Rapid coughing fits often followed by a loud, high-pitched "gasp" sound breathe in.
• Vomiting - Vomiting usually occurs after a coughing fit.
• Tiredness after coughing fits and poor sleep.
• increases a person's risk of developing the disease lung infection. [2+3]

5. 5
Diagnosing of Pertussis
Diagnosis is done by cultures or by polymerase chain reaction (PCR) or serologically
Culture diagnosing of pertussis
Nasopharyngeal bacterial culture obtained from throat swab or suction is the best way to
diagnose whooping cough (Sensitivity 58%, specificity 100%). Low sensitivity illnesses
and elderly people over two weeks, because Lower bacterial load, resulting in higher risk
of errors negative result. Oral fluid samples are not very reliable because risk of microbial
contamination. Fast shipping due to the declining survival rate of B. pertussis, testing
samples are essential in transportation. Cultivation usually takes 4-5 days, but it is also
possible it takes up to 12 days, making it the slowest way to diagnose
Polymerase chain reaction (PCR)
PCR testing of nasopharyngeal specimens is rapid Diagnosis, usually within hours,
sensitive (77-97%) and specificity (88-97%). While nasopharynx Swabs have the highest
sensitivity and are accepted by some laboratories Nose or throat swab. Testing should
ideally be done within the first four weeks of illness. Modern techniques such as real time
PCR (RT-PCR) have a higher sensitivity, but have been concerns about cross-reactivity
with other Bordetella species, such as B holmensii, as well as the inability to distinguish
live or dead bacteria that can cause false positives diagnosis. Newer techniques such as
four-target RT-PCR are being developed to avoid cross reactivity.
Serologically
The test for IgG against the pertussis toxin can be carried out twice weeks after the illness
and up to the eighth week. The results with test blood (sensitivity 88-92%, specificity 98-
99%) or oral fluid or a throat swab (sensitivity 80%, specificity 97%) are comparable.
Performing oral fluid tests is easier, in particular in children, but this medium is not often
available in elementary school care and may instead be issued by public health authorities
direct. Serology is not recommended in infants and patients vaccinated in the previous
year because the test is not possible distinguish vaccine-induced or maternal antibodies
from infection-induced antibodies. [1]

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Prevention from Pertussis
The best way to prevent whooping cough infection is to have a Whooping cough vaccine.
Does not contain pertussis vaccine Live bacteria and cannot infect you. in children, it is
usually given as an injection with other vaccines. The most common form is called DTaP.
this mixture Vaccine also protects against other infections called Diphtheria and tetanus.
The first dose is given for two months at the age of. Make sure your child gets all doses of
the vaccine time. Your healthcare provider will tell you the schedule for Vaccines help you
keep track of when doses are needed. Some children with neurological diseases and
seizures may suffer Not receiving or delaying getting the pertussis vaccine. your health
Your provider can also tell you about any risks or causes You or your child will not be
given the whooping cough vaccine. Protection from early childhood vaccination can be
worn turning off. All adults between 19 and 64 years old need whooping for onetime cough
booster vaccine. This is usually the same as Tetanus vaccine booster (called TdaP). 65-
year-old adult and the elderly need a disposable whooping cough booster if They will be
in close contact with babies under 12 years of age Months. Also recommended for pregnant
women Whooping cough vaccine in the second or third trimester Every pregnancy to
protect the newborn baby. If you suspect you have whooping cough, get tested and get
treatment immediately. If you are in close contact People with whooping cough, please
consult your healthcare provider If you need to start antibiotic treatment.
Other steps you can take to help reduce your and your Children's risk of whooping
cough and other respiratory infections include:
• Wash your hands with soap and water or use hand sanitizer
Use alcohol-based hand sanitizer and let others wash their hands
Use your hands before holding or touching your baby.
• Avoid touching your eyes, nose and mouth.
• Keep 6 feet away from the person who is sneezing or coughing.
If you have a cold-like symptom, you should do the following:
• Cover your mouth and nose when coughing or sneezing
• Wash your hands frequently and properly
• Refrain from kissing others and stay as far away as possible
from babies and other healthy people. [2+3]
Treatments used for Pertussis
It's important to see your doctor as soon as you start. the presence of symptoms. Although
it can be difficult to know in advance cold symptoms if your cough gets worse or yours the
child has not received the vaccine, it is best to be tested. Early treatment, ideally when
symptoms are more similar to colds are very important because they can cause the infection
is less serious and can prevent it from spreading to others. The earlier you start taking an
antibiotic for a disease, the more likely to avoid whooping cough spells that last for weeks.
Sometimes the infection is so serious that treatment should be carried out in a hospital.
Babies are at high risk of needing treatment for hospital. Oxygen and intravenous (IV)
fluids may be necessary because of severe coughing fits. [2+3]
Taking actions

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Conclusion
Whooping cough is a highly contagious disease caused by pertussis bacteria and may lead
to death, particularly in infants less than 12 months of age. Whooping cough is preventable
but Although it can be prevented by routine vaccination, it still affects many people, it can
have serious complications including death. Management is only supportive. The majority
need to be vaccinated to help protect those too young to be vaccinated.
References:
1- Gopal, D.P., Barber, J. and Toeg, D., 2019. Pertussis (whooping cough). bmj, 364.
2- Panitch, H., Moore, K.V.H. and Kulkarni, H.S., 2015. What is pertussis (whooping cough)?. American
journal of respiratory and critical care medicine, 191(4), p.P5.
3- (2021), Pertussis (Whooping Cough). Journal of Midwifery & Women's Health, 66: 703-
704. https://doi.org/10.1111/jmwh.13299 (PDF file)
4- Hewlett, Erik L.; Damron, F. Heath; Wong, Ting; Fernandez, Julieta; Sisti, Federico; Zacca, Federico;
Gonyar, Laura A.; Hoffman, Casandra L. (2019-06-25). "Bordetella pertussis Can Be Motile and
Express Flagellum-Like Structures". mBio. 10 (3): e00787–19. doi:10.1128/mBio.00787-19 (PDF)
5- Contribution of pertussis toxin to the pathogenesis of pertussis disease, Nicholas H. Carbonetti
2015 Nov; 73(8): ftv073. doi: 10.1093/femspd/ftv073 (PDF file)