Pertussis infection: Epidemiology, microbiology, and pathogenesis
- Paul Cornia, MD
Paul Cornia, MD
- Associate Professor of Medicine
- University of Washington
- Benjamin A Lipsky, MD, FACP, FIDSA, FRCP (London), FRCPS (Glasg)
Benjamin A Lipsky, MD, FACP, FIDSA, FRCP (London), FRCPS (Glasg)
- Emeritus Professor of Medicine
- University of Washington
- Visiting Professor of Medicine
- Teaching Associate, Green Templeton College
- University of Oxford
- Section Editors
- Stephen B Calderwood, MD
Stephen B Calderwood, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine (Microbiology and Immunobiology)
- Harvard Medical School
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Pertussis, also known as "whooping cough," is a highly contagious acute respiratory illness caused by Bordetella pertussis. Sydenham is credited with naming the illness pertussis in 1679, from the Latin term meaning "intense cough." In addition, the Chinese term for pertussis translates to "the 100-day cough." These names describe the key clinical features of infection. However, the classic clinical manifestations of pertussis infection (cough with paroxysms, inspiratory whoop, and posttussive emesis) are frequently absent in adolescents and adults.
The microbiology, epidemiology, and pathogenesis of pertussis are reviewed here. The clinical manifestations, diagnosis, management, and prevention of pertussis are discussed separately. (See "Pertussis infection in adolescents and adults: Clinical manifestations and diagnosis" and "Pertussis infection in infants and children: Treatment and prevention" and "Pertussis infection in infants and children: Clinical features and diagnosis".)
Pertussis is caused by the gram-negative coccobacillus B. pertussis, a strict human pathogen with no known animal or environmental reservoir . The organism is fastidious, surviving only a few hours in respiratory secretions and thus requiring special media for culture.
Eight additional Bordetella species have been described: B. parapertussishu, B. parapertussisov (ovine-adapted parapertussis), B. bronchiseptica, B. avium, B. hinzii, B. holmesii, B. trematum, and B. petrii . Three of these species (B. parapertussis, B. bronchiseptica, and B. holmesii) can cause respiratory illness in humans. B. parapertussis may cause a spectrum of disease ranging from a nonspecific upper respiratory tract illness to classic pertussis (ie, clinically indistinguishable from that of B. pertussis) [3,4]. B. bronchiseptica causes respiratory infections in a variety of mammals; infection in humans can occur in immunocompromised hosts with animal exposure . B. holmesii infection has been described in the setting of septicemia and respiratory infection clinically similar to classic pertussis [6-9].
Pertussis is a highly contagious respiratory illness. In adolescents and adults, infection may result in a protracted cough and is occasionally associated with substantial morbidity. In children and particularly infants, morbidity is more often substantial and the disease may be fatal.
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