Article Sections

Introduction

Bordetella pertussis is a gram-negative coccobacilli that causes pertussis (whooping cough), a vaccine-preventable illness characterized by paroxysmal coughing often followed by a high-pitched inspiratory whoop.

Pathophysiology and risk factors

Bordetella pertussis is highly contagious and spreads through sustained contact with respiratory droplets (eg, coughing, sneezing) from infected individuals.  B pertussis has unique virulence factors (eg, adhesins, filamentous hemagglutinin) that facilitate attachment to and colonization of ciliated respiratory epithelium in the nasopharynx and lower respiratory tract.  Once attached, B pertussis secretes exotoxins that damage ciliated respiratory epithelium:

  • Pertussis toxin:  Activates intracellular adenylate cyclase to interfere with cellular signaling and inhibit phagocytic activity, impairing the patient's immune response. 
  • Tracheal cytotoxin:  Damages ciliated epithelial cells, leading to impaired mucociliary clearance with subsequent microaspiration and severe paroxysmal cough. 

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