Bordetella Pertussis Ogilvie 1

Bordetella Pertussis:

An Open Ended Disease

Olivia Ogilvie

Salt Lake Community College

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The highly contagious, respiratory disease Pertussis, also known as ‘whooping

cough’ is most common among children and is caused by the bacteria Bordetella

Pertussis (Bouchez, et al., 2018). The disease is vaccine-preventable and has been since

the 1950’s; however there continue to be cases that lead to mortality today (Bouchez, et

al., 2018). The disease has diverse characteristics and different symptoms when mixed

with other diseases or infections; this has lead to it being a continued subject of study for

many scientists (Bouchez, et al., 2018). Whooping cough is passed to other hosts via

direct airborne particles, which are released by an individual while coughing (Bouchez, et

al., 2018). The purpose of this research paper is to discuss the effects of the required

vaccine, DTaP on this disease and how it can prevent death in infants and children.

In order to understand the need and benefit of the vaccine, it is important to

understand how our immune system naturally works to fight off infections and diseases;

our bodies are constantly being bombarded by germs, bacteria and viruses that attack and

multiply which is the cause of the illness (CDC, 2018). There are many different

techniques that the immune system uses to fight off these infections; such as, red blood

cells carrying oxygen throughout the body and the white blood cells: macrophages, B-

lymphocytes and T-lymphocytes (CDC, 2018). Macrophages eat up germs and dead

cells; they then leave behind antigens, which are pieces of the germs and dead cells that

they just consumed (CDC, 2018). These antigens are recognized as intruders and the

body brings in antibodies to fight them off (CDC, 2018). The macrophages then detect

the intruders using a receptor known as Toll-like Receptors, which bind themselves to

sugars, RNA and DNA (Saldana).

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The B-lymphocytes and T-lymphocytes are both a type of white blood cells that

are meant to defend the body (CDC, 2018). B-lymphocytes create the antibodies that

fight off the antigens that the macrophages made from the germs (CDC, 2018). The T-

lymphocytes are then in charge of fighting the cells in the body that were already infected

by the bacteria or virus (CDC, 2018). The body keeps these T-lymphocytes around as

memory cells to help the immune system start fighting as soon as they recognize a germ

that has previously entered the body (CDC, 2018). Vaccines have been created to help

mimic this process and prevent diseases.

The purpose of a vaccine is to help the body create immunity to infections by

imitating the bacteria or virus related to it (CDC, 2018). The vaccine rarely causes an

infection or illness; the main role of the vaccine is to make the immune system create the

T-lymphocytes and antibodies produced by the B-lymphocytes (CDC, 2018). By using

the vaccine to imitate the disease the body creates a supply of the memory cells that are

ready to attack the real disease in the future (CDC, 2018). The time frame for the vaccine

to work and the entrance of the actual disease may line up in a way that doesn’t allow the

immune system to prepare to fight fast enough, allowing the body to get sick; this is rare

but possible (CDC, 2018).

There are different types of vaccines that can be used dependent on the virus or

bacteria that is being fought (CDC, 2018). Live vaccines contain a living virus or

bacteria, which is weakened, making them very helpful in teaching the immune system

what to fight without getting the patient sick (CDC, 2018). Another type of vaccine is

known as a toxoid vaccine, which fights bacteria that produces toxins (CDC, 2018). The

DTaP vaccine, the designated vaccine used to fight off the pertussis disease, is known as
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a toxoid (CDC, 2018). This vaccine can begin to wear off after time so there is a need for

booster doses after a few years to keep the immune system ready to fight off the infection

(CDC, 2018).

The original vaccine for Pertussis did not come about until the 1940’s, before the

vaccine, whooping cough infected around 200,000 children a year with upwards of 7,000

deaths (McKenna, 2013). The bacteria, Bordetella pertussis creates a toxin that ruins the

coating of the lungs bringing forth coughing fits that can lead to seizures and brain

damage in sever cases (McKenna, 2013). The DTaP vaccine imitates those toxins so that

the T-lymphocyte and B-lymphocytes can come in and fight off the disease (CDC, 2018).

The alarming amount of deaths related to this disease prior to the introduction of

the vaccine brought forth many scientists looking for a cure but found it to be quite hard.

In 1906 Jules Bordet and Octave Gengou discovered the Bordetella Pertussis bacteria as

the cause of the whooping cough disease, however they were not able to do much with

that information (Shapiro-Shapin, 2010). During the First World War there was not much

time put into developing a vaccine for the disease; once the war was over the health

department was given new funds to expand their laboratories and studies (Shapiro-

Shapin, 2010). In order to fill the departments with their limited budget, directors would

hire female scientists to do research for less pay; Pearl Kendrick was one of those women

(Shapiro-Shapin, 2010). She was known for being a great student; she received a Doctor

of Science in Bacteriology from Johns Hopkins University in 1932 and studied at

Columbia Unversity (Shapiro-Shapin, 2010).

Kendrick performed extensive research on the pertussis strain, taking her studies

to Grand Rapids where there was a rise in infected children of that area (Shapiro-Shapin,
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2010). She invited Grace Eldering to join her and they both worked to develop methods

to grow the bacteria and create a vaccine using it (Shapiro-Shapin, 2010). They worked

effortlessly for years and by 1940 the pertussis vaccine was being distributed across

America (Shapiro-Shapin, 2010). In 1943 the American Academy of Pediatrics approved

the vaccine and the American Medical Association urged the nation to use the vaccine

(Shapiro-Shapin, 2010). The results of the vaccine were staggering with 51 cases out of

100,000 residents with a death rate of <1 out of 100,000 in 1948 compared to 209 cases

out of 100,000 with a death rate of roughly 6 out of 100,000 just 14 years earlier

(Shapiro-Shapin, 2010).

These advances have continued to save lives in regards to the pertussis disease

however since 1980 the number of cases involving whooping cough has been slowly

increasing (Immunize, 2018). The majority of the cases being reported are concentrated

in developing countries, however, it continues to show up more frequently in countries

that have a large vaccine coverage such as the United States, the United Kingdom and

Australia (de Celles, Magpantay, King, & Rohani, 2016). Infants younger than one year

have been the most greatly affected by the disease; the reasons for the re-emergence of

these cases are believed to be caused by an increasing immunity to the acellular vaccine

(Immunize, 2018). There were two vaccines used to treat pertussis; whole-cell and

acellular, the latter was developed more recently as a solution to the side effects caused

by the whole-cell vaccine (Bouchez, et al., 2018).

Although there has been vaccine coverage for well over 50 years, they have not

developed a solution to protect against the transmission of the disease or for the

continued vaccine immunity (de Celles, Magpantay, King, & Rohani, 2016). This has
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created an issue where children are continually being subjected to the bacterium that

leads to pertussis (de Celles, Magpantay, King, & Rohani, 2016). Many studies have been

conducted to determine the resurgence of this disease and through those studies they have

been able to observe a shift in allele frequencies involving Bordetella Pertussis antigens

(de Celles, Magpantay, King, & Rohani, 2016). It has been noted that the increase in the

disease aligned with that of an entrance of a pertussis toxin allele promoter, which could

be a cause for the rise in the number of cases (de Celles, Magpantay, King, & Rohani,

2016).

Having a complete understanding of the pertussis epidemiology is no where near

occurring at this point; studies indicate that there is a large amount of variability that goes

into each case (de Celles, Magpantay, King, & Rohani, 2016). It is important to recognize

these variations and the complexity of this disease to help develop a more permanent and

beneficial cure. The bacteria’s ability to adjust to the vaccine and develop an immunity to

it is a whole other field of study that will help bring answers to many questions involving

finding a cure. The value of the vaccine has not diminished and it is still extremely

important that parents are vaccinating their children to avoid a greater spread of this

disease.
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References

De Celles, M., Magpantay, F., King, A., & Rohani, P. (2016, January 13). The pertussis
enigma: Reconciling epidemiology, immunology and evolution. Retrieved
November 11, 2018, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721090/

Ask the Experts. (2018, September 10). Retrieved November 11, 2018, from
http://www.immunize.org/askexperts/experts_per.asp

Understanding How Vaccines Work. (2018, July). Retrieved November 9, 2018, from
https://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-
color-office.pdf

Saldana, J. I. (n.d.). Macrophages. Retrieved November 11, 2018, from

https://www.immunology.org/public-information/bitesized-
immunology/cells/macrophages

McKenna, M. (2013, October 1). Why Whooping Cough Vaccines Are Wearing Off.
Retrieved November 10, 2018, from
https://www.scientificamerican.com/article/why-whooping-cough-vaccines-are-
wearing-off/

Shapiro-Shapin, C. G. (2010). Pearl Kendrick, Grace Eldering, and the Pertussis

Vaccine. Emerging Infectious Diseases, 16(8), 1273-1278.
https://dx.doi.org/10.3201/eid1608.100288

Bouchez, V., Guglielmini, J., Dazas, M., Landier, A., Tubiana, J., Gulliot, S., . . . Brisse,
S. (2018, June). Genomic Sequencing of Bordetella pertussis for Epidemiology
and Global Surveillance of Whooping Cough. Retrieved November 8, 2018, from
http://web.b.ebscohost.com.libprox1.slcc.edu:2048/ehost/pdfviewer/pdfviewer?vi
d=7&sid=9e03ffd8-019d-474c-8b55-8093cbfc7415@sessionmgr104