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    Bordetella Pertussis

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    tummalapalli venkateswara rao
    This document provides information about Bordetella pertussis and whooping cough. It discusses how Jules Bordet and Gengou discovered the bacteria in 1900 and identified it as B. pertussis. Whooping cough is very contagious and causes severe coughing fits. The name comes from the whooping sound made when inhaling after coughing. B. pertussis is gram-negative and produces several toxins that are virulence factors like pertussis toxin and filamentous hemagglutinin. Whooping cough has 3 stages and can cause serious complications. It is diagnosed through culture, PCR or serology. Immunization with DTaP vaccine can prevent whooping cough.

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    Bordetella Pertussis

    Uploaded by

    tummalapalli venkateswara rao
    292 views53 pages
    This document provides information about Bordetella pertussis and whooping cough. It discusses how Jules Bordet and Gengou discovered the bacteria in 1900 and identified it as B. pertussis. Whooping cough is very contagious and causes severe coughing fits. The name comes from the whooping sound made when inhaling after coughing. B. pertussis is gram-negative and produces several toxins that are virulence factors like pertussis toxin and filamentous hemagglutinin. Whooping cough has 3 stages and can cause serious complications. It is diagnosed through culture, PCR or serology. Immunization with DTaP vaccine can prevent whooping cough.

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    Bordetella pertussis

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    Bordetella pertussis

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    This document provides information about Bordetella pertussis and whooping cough. It discusses how Jules Bordet and Gengou discovered the bacteria in 1900 and identified it as B. pertussis. Whooping cough is very contagious and causes severe coughing fits. The name comes from the whooping sound made when inhaling after coughing. B. pertussis is gram-negative and produces several toxins that are virulence factors like pertussis toxin and filamentous hemagglutinin. Whooping cough has 3 stages and can cause serious complications. It is diagnosed through culture, PCR or serology. Immunization with DTaP vaccine can prevent whooping cough.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    292 views53 pages

    Bordetella Pertussis

    Uploaded by

    tummalapalli venkateswara rao
    This document provides information about Bordetella pertussis and whooping cough. It discusses how Jules Bordet and Gengou discovered the bacteria in 1900 and identified it as B. pertussis. Whooping cough is very contagious and causes severe coughing fits. The name comes from the whooping sound made when inhaling after coughing. B. pertussis is gram-negative and produces several toxins that are virulence factors like pertussis toxin and filamentous hemagglutinin. Whooping cough has 3 stages and can cause serious complications. It is diagnosed through culture, PCR or serology. Immunization with DTaP vaccine can prevent whooping cough.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 53

    BORDETELLA PERTUSSIS

    WHOOPING COUGH
    Dr.T.V.Rao MD

    DR.T.V.RAO MD

    A TRIBUTE TO BORDET - GENGOU

    DR.T.V.RAO MD

    WHAT IS WHOOPING COUGH


    Whooping Cough (Pertussis) is a bacterial infection of the lungs which is caused by a bacterium Bodetella pertussis. It is a very contagious disease which causes coughing with little or no fever. The coughing may be so severe that it leads to vomiting and aspiration.
    DR.T.V.RAO MD

    HOW THE NAME WHOOPING DERIVED Whooping cough is an infectious bacterial disease that causes uncontrollable coughing. The name comes from the noise you make when you take a breath after you cough. You may have choking spells or may cough so hard that you vomit.
    DR.T.V.RAO MD

    IDENTIFICATION BODETELLA
    Jules Bordet and Gengou contributed for discovery 1900 Identified as small bacilli in children with Whooping cough. Bodetella pertussis ( Intense cough ) Other related Bacteria B.parapertussis B.brochoseptica B.avium
    DR.T.V.RAO MD

    BORDETELLA PERTUSSIS ( B G BACILLUS )


    Gram negative organism Small, ovoid,cocobacillus. Length is 0.5 microns Have bipolar metachromatic granules when stained with Toluidine blue
    DR.T.V.RAO MD

    BODETELLA PERTUSSIS ( B G BACILLUS)


    Small ovoid coccobacillus 0.5 microns On repeated cultures becomes become larger thread like bacilli. Non motile, Non sporing Capsulated loose on repeated culturing

    DR.T.V.RAO MD

    OTHER CHARACTERS
    Do not swell in the presence of antigen. Loose clumps of bacilli appear as thumb print appearance with clear space between the organisms. Freshly isolated strains have fimbria.

    DR.T.V.RAO MD

    CULTURE CHARACTERS
    Aerobic Not anaerobic Grows optimally at 35 0 to 370 c Preferred medium Bordet Gengou glycerin potato blood agar

    Blood for neutralizing inhibitory substances formed during bacterial growth.


    Charcoal also serves the same purpose.
    DR.T.V.RAO MD

    MERCURY DROP COLONIES ON BORDET-GENGOU MEDIUM


    Growth takes longer up to 48 72 hours On blood agar appear as small dome shaped opaque viscid grayish white retractile Resembles bisected pearly or mercury drops
    DR.T.V.RAO MD

    10

    ALUMINUM PAINT APPEARANCE


    Colonies surrounded by hazy zone of hemolysis Confluent growth presents as aluminum paint.
    DR.T.V.RAO MD

    11

    BIOCHEMICAL REACTIONS
    In active do not ferment sugars Indole test + Reduce Nitrates Utilize citrates Splits urea

    Catalase +
    Oxidase +
    DR.T.V.RAO MD

    12

    RESISTANCE
    Killed by heat at 550c for 30 mt Drying and disinfectants kill the organism Survive outside for 5 days 3 days on cloths Few hours on paper

    DR.T.V.RAO MD

    13

    ANTIGENIC CHARACTERS AND VIRULENCE


    Agglutinogens - Species specific surface agglutinogens with capsule K antigens or fimbria 14 agglutinin factors are identified Factors 7 is common in all species Factor 1- 6 in only B pertussis Factor 12 in B.brochoseptica

    Factor 14 in B Para pertussis

    DR.T.V.RAO MD

    14

    VIRULENCE FACTORS
    These virulence factors include adhesions such as filamentous hem agglutinin, agglutinogens, peractin, and fimbriae as well as a number of toxins including pertussis toxin, acetylate cyclase toxin, trachael cytotoxins, Dermonecrtoic toxin and heat-labile toxin (CDC, 2005).
    DR.T.V.RAO MD

    15

    PATHOGENESIS OF B.PERTUSSIS
    Like most Gram negative pathogens, B. pertussis also contains a Lipopolysaccharide coat that acts as an Endotoxin and can aid colonization by agglutinating human cells (Steele, 2004).
    DR.T.V.RAO MD

    16

    VIRULENT MOLECULES

    DR.T.V.RAO MD

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    TOXIN CELLULAR ACTION.

    DR.T.V.RAO MD

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    MECHANISM OF INFECTION
    1,2,3 are common infective strains vaccines contain all the three Agglutinogens promoting virulence by helping bacteria to attach to respiratory epithelial cells
    DR.T.V.RAO MD

    19

    PERTUSSIS TOXIN
    Pertussis toxin MW 1,17,000 Hexamer protein composed of 6 subunits with A B structure A has enzymatic activity it can be toxoided Pertussis toxin is the major component of Acellular Pertussis vaccine.

    DR.T.V.RAO MD

    20

    NATURE OF TOXIN
    It produces a highly lethal toxin (formerly called Dermonecrtoic toxin) which causes inflammation and local necrosis adjacent to sites where B. pertussis is located. The lethal toxin is a 102 kDa protein composed of four subunits, two with a mw of 24kDa and two with mw of 30 kDa.
    DR.T.V.RAO MD

    21

    PERTUSSIS TOXIN
    Causes pathogenesis

    Present only in B.pertussis


    Pertussis toxin is expressed on the surface, secreted into the surrounding medium

    Posses Biochemical and Biological activity of producing lymphocytosis producing factor causes Lymphocytosis
    Acts as Histamine sensitizing factor Islet activating function causes excessive Insulin secretion.
    DR.T.V.RAO MD

    22

    FILAMENTOUS HEMAGGLUTININ
    One of the Hemagglutinins produced by B.pertussis Filamentous Haemagglutinnins adheres to cilia of the respiratory epithelium and to erythrocytes

    Helps in binding to respiratory epithelium


    DR.T.V.RAO MD

    23

    OTHER TOXINS
    Adenylate cyclase
    Enters the target cells and acts as toxin

    It acts by catalyzing the production of cAmp by various types of cells. Heat labile Toxin
    Cytoplasmic protein present in Bordetella

    Dermonecrtoic and lethal in Mice


    DR.T.V.RAO MD

    24

    TRACHEAL TOXIN
    L M W peptidoglycan Causes ciliary damage, produced by all Bodetella It induces ciliary damage in hamster tracheal ring Lipolysacchardie acts as in Gram ve bacilli

    Pertactin OMP produces immunity in mice.

    DR.T.V.RAO MD

    25

    VARIATION SMOOTH TO ROUGH


    B pertussis may alter from smooth to rough variation

    Phase I to Phase II Phase III Phase IV( rough stage ) which is rough and avirulent form
    DR.T.V.RAO MD

    26

    PATHOGENICITY
    An obligate parasite Intranasal inoculation in mice induces a characteristic patches and intensive pneumonia like In humans Incubation is 1 to 2 weeks
    DR.T.V.RAO MD

    27

    INCUBATION IN WHOOPING COUGH


    The incubation period (the time between infection and the onset of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days.
    DR.T.V.RAO MD

    28

    STAGES OF INFECTION
    1 Catarrhal 2 Paroxysmal 3 Convalescent Each stage lasts 2 weeks Catarrhal stage is Maximal infective Antibiotics are useful.
    DR.T.V.RAO MD

    29

    PAROXYSMAL STAGE
    Cough increases distinctive bouts

    Violent spasms of continuous coughing


    With violent act of cough, air enters into empty lung with characteristic whoop

    Enters into next stage


    Leads to convalescence And severity of cough decreases Total disease lasts for 6- 8 weeks.
    DR.T.V.RAO MD

    30

    VIOLENT PAROXYSMS OF COUGH

    DR.T.V.RAO MD

    31

    COMPLICATIONS
    The violent bouts of cough leads to Subconjuctival hemorrhage Subcutaneous emphysema Bronchopneumonia Lung collapse Neurological complications Epilepsy, paralysis, mental retardation, blindness, deafness.
    DR.T.V.RAO MD

    32

    EPIDEMIOLOGY
    Predominately a pediatric disease Highest in the 1st year of life Maternal antibodies are not protective. Females suffers more than males. World wide in distribution Epidemics occurs periodically. In early stage of infection droplets and fomites contaminated by oropharengeal secretion are infective. Non immune rarely escape infection
    DR.T.V.RAO MD

    33

    EPIDEMIOLOGY
    House hold contacts at risk Chronic carriers are not known B.pertussis - 95 %

    B.parapertussis 5%
    B.brochoseptica occasionally occur Some times Adenovirus, Mycoplasma pneumonia may mimics whooping cough.

    DR.T.V.RAO MD

    34

    HOW WHOOPING COUGH DIAGNOSED


    Since the early symptoms are so non-specific, pertussis is usually not diagnosed until the appearance of the characteristic cough. Pertussis can be confirmed by taking cultures of respiratory fluids for examination in the laboratory. This involves taking a sample of secretions from the nose or throat and identifying the pertussis bacteria in the secretion

    DR.T.V.RAO MD

    35

    DIAGNOSIS
    Isolation by culture PCR Direct fluorescent antibody Serological testing

    DR.T.V.RAO MD

    http://medinfo.ufl.edu/year2/mmid/bms5300/images/d7053.jpg

    36

    LABORATORY DIAGNOSIS
    Microscopy Culture. Microscopy Demonstration of Bacilli in respiratory secretions. Florescent Antibody methods

    DR.T.V.RAO MD

    37

    DR.T.V.RAO MD

    38

    COUGH PLATE METHOD


    Culture plate held at 1015 cm infront of the mouth when the patient is coughing spontaneously or induced cough Droplets of respiratory exhaled impinge on the media. Helpful as bed side investigation
    DR.T.V.RAO MD

    39

    COUGH PLATE METHOD

    DR.T.V.RAO MD

    40

    NASOPHARYNGEAL SWAB
    Secretion from the posterior pharyngeal wall are collected with cotton swab on a bent wire passed from the oral cavity A Wests post nasal swab is used for collection of specimen.
    DR.T.V.RAO MD

    41

    PER NASAL SWAB


    Swab on a flexible wire is passed along the floor of the nasal cavity and material collected from Pharyngeal wall Dacron or Calcium alginate swabs are better
    DR.T.V.RAO MD

    42

    TRANSPORT MEDIUM
    Transferred into Casamio acid solution at pH 7.2 in modified Stuarts medium Glycerin potato blood agar of Bordet Gengou Adding Pencillin becomes more selective
    DR.T.V.RAO MD

    43

    IDENTIFICATION OF BACTERIA
    The culture plates are incubated at 360c The bacteria are identified by Microscopy and slide agglutination

    Immunofluorescence methods
    DR.T.V.RAO MD

    44

    SEROLOGY
    Paired serum sample for detection of antibodies Gel precipitation testing Complement fixation test Detection of Ig A by ELISA from nasopharyngeal secretions.
    DR.T.V.RAO MD

    45

    EARLY IMMUNIZATION IS BEST SOLUTION TO PREVENT THE PERTUSSIS

    DR.T.V.RAO MD

    46

    HOW WHOOPING PREVENTED


    Pertussis can be prevented by the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, a cellular pertussis) vaccine. These important immunizations are routinely given in five doses before a child's sixth birthday.
    DR.T.V.RAO MD

    47

    PROPHYLAXIS
    Alum absorbed vaccine is better Administered in combination with Diphtheria, and tetanus toxoid B pertussis acts as an adjuvant Early immunization, is essential in prevention of infection. Later doses are given at the interval of 4 6 weeks intervals, before 6 moths 3 doses are completed.

    DR.T.V.RAO MD

    48

    BOOSTER DOSES
    A booster at the end of the 1 st year Another dose at 4th year Chemoprophylaxis with Erythromycin when exposed to contacts in the vicinity Complications with vaccination Post vaccinial encephalopathy 5 10 million doses Neurotic complications Stop further vaccination Do not vaccinate after 7 years
    DR.T.V.RAO MD

    49

    ADVANTAGES OF ACELLULAR VACCINE


    An acellular vaccine containing whole antigen has been developed and found to elicit good antibody response with fewer side effects. It has replaced the classical vaccine in Japan since 1981 with success, with fewer out breaks and less side effects. whooping cough vaccine can be made from various components of the Bodetella pertussis bacterium, rather than the whole organism. This "acellular" vaccine works well but has fewer side effects than the traditional "whole cell" version.
    DR.T.V.RAO MD

    50

    ACELLULAR VACCINES
    Contain the Pertussis bacilli Contain PT FHA Agglutinogens 1, 2, 3 Produces immunity in 90 % of individuals Immunity in only 50 % by 12th year

    DR.T.V.RAO MD

    51

    TREATMENT
    Penicillin is not useful 10 days of Erythromycin is useful in early infection

    Chloramphenicol and Cotromoxazole are effective.


    DR.T.V.RAO MD

    52

    Programme Created by Dr.T.V.Rao MD for Medical and Paramedical Students


    Email doctortvrao@gmail.com

    DR.T.V.RAO MD

    53

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