Microbiology

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Original Forum
Microbes can be involved in diseases of any of our vital organ systems but of all of them, the most common diseases we see our physician for treatment is our respiratory system. The moment we have any difficulty taking in a breath of air, it can be a life-threatening crisis. Our respiratory system is a perfect microenvironment for microbes; it is warm, moist, has plenty of oxygen and a supply of mucus so why do we not have massive colonies of microbes? Or, do we?  Our immune systems spend much effort protecting our airways but there are a few microbes that have evolved mechanism to evade our immune systems. Bordetella pertussis (better known by its disease name, Whooping cough) is one such Gram-negative bacterium that has succeeded in causing great pestilence before a vaccine was discovered. Despite this, some choose not to have the vaccine and yearly outbreaks of Whooping cough claims the lives of children each year in the US. Mortality is highest in infants despite those who have begun their vaccine series.  Review chapter 22 of your textbook on Diseases of the Respiratory System.  Review information on the vaccine for Whooping CoughAnd, the facts about Whooping cough from the CDC Upon review of the information sources and your own research, choose ONE of the topics to address in exposition forum.

Topic 1. Defend the resurgence of Whooping cough as due to waning immunity.

Topic 2. Present an argument to support lack of vaccination as a cause for resurgence.Make sure to address these questions in your exposition;  What is the mechanism(s) that Bordetella pertussis uses to invade epithelial cells in the lungs?  Why does this Gram-negative bacteria cause the characteristic cough that it does?  Why is infant mortality high?  What role does herd immunity play in the spread of an infectious disease like Whooping cough?

Student Response

Eric
B. pertussis uses an adhesin that attaches to cells which grows bacteria that produce exotoxins. After the cells have been invaded, increased levels of cyclic adenosine monophosphate allows for a disruption in cells using their signals. In addition, the a cytotoxin is produced which results in the accumulation of mucus in the lungs (Parker, 2016). This is what leads a person to cough. The requirement for oxygen to able be exchanged in the lungs through the alveoli are disrupted and by coughing, it allows for more “force” to be used to help this to happen.The coccobacillus found in B. pertussis are able to inflame the airway which causes someone to have a harder time breathing and especially after they’ve been coughing multiple times (Parker, 2016). Basically, the multiple causes of the “whooping” effect are due to the person using more effort to inhale after this period.   Infant mortality is high due to their anatomy and immune responses. Their bodies are not as well developed as adults or even children which can cause their ribs to be fractured and also leads to infections which they may have yet to develop an immunity to (Parker, 2016).  This cough is transmittable through air droplets by an infected individual. Due to the likeliness of transmission in public, it would be advisable for a person to distance themselves from the public while they have it. This would limit the spread of the infectious disease as it would with others. It is also recommended that children get vaccinated for this very reason. B. pertussis has been steadily declining over the years due to vaccinations but is now recently reemerging due to the lack of these vaccinations (Parker, 2016). In school environments, playgrounds, and public areas, the whooping cough can be easily transmitted to other children due to the lack of their knowledge to understand how it is transmitted and the bacteria that may be present on their hands which they can easily spread. What degree are you working toward? Right now, I am completing this course as a prerequisite for nursing. It is one of my last classes!What is your progress in accomplishing your educational goals and what courses are you starting next month? My educational goals are coming to a near-end as I have completed many of the courses that I wanted and I am now looking into a nursing program which I will apply to shortly after this course. I will be starting Anatomy and Physiology next month and I am so excited for that because I know a ton of that information already and it will be a great refresher. Why did you choose these courses?I chose these courses because they are required before I can continue onto my future career. 

References

Parker, N. (2016). Microbiology. OpenStax. Retrieved 2018

Megan
Reported cases of whooping cause are on the rise in industrialized countries. Mooi et al (2009) have attributed this to a combination of many factors:

  1. Improved diagnostic techniques
  2. Reduction in vaccinations
  3. Pathogen adaptation
  4. Reduced effectiveness of vaccines

According to He (2016), the type of vaccine used has also shown to have an effect on the resurgence of whooping cough. The most commonly used vaccines for whooping cough in industrialized countries are acellular vaccines (ACVs). Whole cell vaccines (WCVs) are more commonly used in developing countries.  As the whooping cough virus mutates, these vaccines are becoming less effective, but the virus mutations are dependent on which type of vaccine (ACV vs WCV) were used. Hamborsky, Kroger, and Wolfe (2015) state that in recent years, the cases of whooping cough in fully vaccinated adolescents and adults is on the rise, indicating that a large part of the increase in whooping cough may be due to pathogen adaptation.B. pertussis attaches to the cilia in the epithelia cells of the lung. Once there, it secretes a toxin which causes the cilia to become immobilized. It also causes inflammation which leads to the buildup of mucus and phlegm. This buildup of mucus in the tracheobronchial tree is what causes the characteristic coughing associated with B. pertussis (Hamborsky, Kroger, & Wolfe, 2015).One study cited by the CDC found that infant deaths represented 83% of deaths due to whooping cough. The infant mortality rate is so high because infants are more likely to develop secondary complications than others who contract whooping cough. These complications include secondary bacterial pneumonia, seizures, encephalopathy, pneumothorax, hernias, and more (Hamborsky, Kroger, & Wolfe, 2015).According to the Center for Disease Control (CDC), herd immunity is not a reliable source of immunity against whooping cough for a few different reasons. First, pertussis is very contagious. Second, the effectiveness of the vaccine decreases over time. Once vaccinated does not mean forever invincible. Finally, ACVs may not be reliable at preventing colonization of B. pertussis, meaning it could still be spread even if the symptoms are mild or nonexistent (National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, 2017).

References

Hamborsky, J., Kroger, A., & Wolfe, C. (2015). Epidemiology and Prevention of Vaccine-Preventable Diseases (13 ed.). Washington D.C.: Public Health Foundation. Retrieved November 6, 2018, from https://www.cdc.gov/vaccines/pubs/pinkbook/pert.htmlHe, Q. (2016, August). Evolution of Bordetella Pertussis. The Pediatric Infectious Disease Journal, 35(8), 915-917. doi:10.1097/INF.0000000000001218Mooi, F. R., van Loo, I. H., van Gent, M., He, Q., Bart, M. J., Heuvelman, K. J., de Greeff, S. C., Diavatopoulos, D., Teunis, P., Nagelkerke, N., … Mertsola, J. (2009). Bordetella pertussis strains with increase toxin production associated with pertussis resurgence. Emerging infectious diseases, 15(8), 1206-13.National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. (2017, August 7). Pertussis Frequently Asked Questions. Retrieved November 6, 2018, from Center for Disease Control and Prevention: https://www.cdc.gov/pertussis/about/faqs.html

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