Show Summary Details
Page of

Bordetella infection 

Bordetella infection

Chapter:
Bordetella infection
Author(s):

Cameron Grant

DOI:
10.1093/med/9780199204854.003.070614_update_001

Update:

Description of Bordetella species updated to include Bordetella hinzii, B. trematum, and B. petrii.

Role of B. pertussis virulence factors in immunoregulation as a potential pathogenic mechanism for severe disease.

Re-emergence of pertussis in many countries since the 1990s and the factors that have contributed to this.

Contribution to global mortality in children less than 5 years old updated.

Summary of newer immunization strategies that seek to prevent disease transmission to infants.

The high proportion of pertussis cases for which the clinical illness is atypical.

Updated information on the serological diagnosis of pertussis.

Current recommendations for antimicrobial therapy and the lack of efficacy of treatments for pertussis-induced cough.

Updated information on local reactions to sequential doses of pertussis vaccine.

Updated on 31 May 2012. The previous version of this content can be found here.
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2015. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy).

date: 28 April 2017

Bordetella are small Gram-negative coccobacilli, of which Bordetella pertussis is the most important human pathogen. It is the cause of whooping cough, which is one of the 10 leading causes of childhood death. Transmission of this highly infectious organism is primarily by aerosolized droplets.

Clinical features—presentation varies with age, immunization and previous infection: (1) infants—apnoea, cyanosis, and paroxysmal cough; (2) nonimmunized children—cough, increasing in severity with distressing, repeated, forceful expirations followed by a gasping inhalation (the ‘whoop’); (3) children immunized in infancy—whooping, vomiting, sputum production; (4) adults—cough, post-tussive vomiting. Atypical mild illness is common. Complications include pneumonia, pulmonary hypertension, seizures and encephalopathy. Most deaths occur in those less than 2 months old.

Diagnosis and treatment—culture lacks sensitivity; the preferred diagnostic methods are polymerase chain reaction (PCR) detection from nasopharyngeal samples and serology (IgG antibodies to pertussis toxin). Macrolide antibiotics are recommended if started within 4 weeks of illness onset.

Prevention—Pertussis vaccines protect against disease more than infection. Preventing severe disease in young children remains the primary goal, hence schedules consist of a three-dose infant series and subsequent booster doses. Acellular vaccines enable immunization schedules to include adolescents and adults. Antibiotic prophylaxis is given when there is an infant at risk of exposure.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.