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Few data exist on asymptomatic carriage of Bordetella species among populations receiving acellular pertussis vaccine. We conducted a cross-sectional study among acellular-vaccinated children presenting to an emergency department (ED). Bordetella pertussis carriage prevalence was <1% in this population, a lower prevalence than that found in recent studies among whole-cell pertussis-vaccinated participants. [ABSTRACT FROM AUTHOR]

What is Known and Objective: Live‐attenuated bacterial veterinary vaccines can constitute an infection risk for individuals with any defect in their phagocytic function, including chronic granulomatous disease, leukocyte adhesion deficiency, myeloperoxidase deficiency, as well as Chediak‐Higashi syndrome, from accidental acquisition of licenced attenuated live bacterial vaccine, at vaccination or from their vaccinated pet. Ownership of small companion animals, including cats and dogs, is popular within the cystic fibrosis (CF) community. These animals require vaccines as part of their routine care, which may involve live viral and bacterial vaccines, with potential for infection in the CF owner. This report examines the scope of current canine and feline vaccines, with particular emphasis on veterinary vaccination strategies against the Gram‐negative pathogen, Bordetella bronchiseptica and describes new vaccine innovations offering protection to both pet and CF owner. Comment: The Gram‐negative bacterium, Bordetella bronchoseptica, may cause respiratory disease in small companion animals, as well as in certain human vulnerable groups, including those with CF. Live licenced veterinary bacterial vaccines for Bordetella bronchiseptica (Kennel Cough) are available for cats and dogs, which are an infection concern for humans with CF who may come into contact with vaccinated animals. Live licenced veterinary bacterial vaccines for Bordetella bronchiseptica (Kennel Cough) are available for intranasal administration to cats and dogs. These vaccines require a withdrawal period of vaccinated animal from vulnerable owner, ranging from 35 days – 11 weeks. Recently, a new dead IM vaccine is now available not requiring exclusion of the vaccinated pet from CF owner. What is new & conclusion: CF pharmacists, hospital pharmacists and community pharmacists are important custodians of vaccine‐related advice to people with CF, who are frequently consulted for such advice. Pharmacists should be aware of the recent innovations in veterinary medicines, so that they can give appropriate advice to people with CF when asked. Immunocompromised patients, that is those with CF or those with any defect in their phagocytic function (chronic granulomatous disease, leukocyte adhesion deficiency, myeloperoxidase deficiency, Chediak‐Higashi syndrome) should avoid exposure to live veterinary bacterial vaccines and seek animal vaccination utilising non‐live vaccines. Most importantly, this manuscript highlights the development of a new veterinary vaccine for dogs, which we want to make the CF healthcare community aware of, which is an acellular dead vaccine, so that those patients with dogs needing annual vaccination can select this vaccine pathway, thereby minimising risk of infection from the vaccine strains and avoiding the social exclusion between CF patient and their pet. CF patients should understand the potential infection implications of live‐attenuated viral and bacterial strains as vaccines, whether these are small companion animals, exotic animals or large farm animals. Patients should make their veterinarian aware of their CF status, so that a safe and efficacious vaccine strategy is used, both mitigating the potential infection risks from live vaccine components with the CF patient, but simultaneously offering maximum immunological protection to the animal. [ABSTRACT FROM AUTHOR]

What is known and objective: The Gram‐negative bacterium, Bordetella bronchiseptica, causes lower airway respiratory disease in people with cystic fibrosis (CF), as well as in companion animals, especially dogs. Presently, there are several acellular vaccines available for B. pertussis but no vaccine available for B. bronchiseptica. However given the shared protein homology between these two closely related species, we wished to explore whether pertussis vaccines may offer some cross‐protection against B. bronchiseptica. Comment: Bordetella pertussis and B. bronchiseptica are closely related phylogenetically, as well as sharing protein homology in several pertussis vaccine components, including (i) pertussis toxin (PT), (ii) filamentous haemagglutinin (FHA), (iii) pertactin and (iv) fimbriae (types 2 and 3). Given that pertussis vaccine contains cross‐reactive antigens with B. bronchiseptica, licensed pertussis vaccines may therefore offer cross‐protection against B. bronchiseptica. What is new and conclusion: Cystic fibrosis pet owners should ensure that they have an up‐to‐date vaccination record relating to their pertussis vaccine. Although no monovalent human pertussis vaccines are currently available, licensed non‐live booster vaccines for B. pertussis are available for individuals in the age range >10 years old. People with CF should ensure that they are adequately and currently protected against pertussis, to avoid whooping cough, which may also offer some cross‐protection against B. bronchiseptica and therefore help further mitigate the risk of zoonotic infection of this organism from pets to their owners. [ABSTRACT FROM AUTHOR]

From 2015 to 2017, 3197 interpretable Bordetella polymerase chain reaction (PCR) tests were performed for 2760 children presenting to our tertiary university hospital. Requests mainly came from the emergency department (62%) and for children older than 1 year (68%). Only 32 PCR (1%) results were positive, mainly in children younger than 1 year (n = 29/32, 90.6%; p <0.001). When focusing on the PCR indications in 2017, we found the requests were mainly based on nonspecific respiratory symptoms and were clinically unjustified in 383 cases (39%). Pediatricians overused Bordetella PCR in clinical practice. They should reserve their requests for cases of young children with symptoms suggestive of respiratory illness and/or incomplete pertussis immunization. [ABSTRACT FROM AUTHOR]

Background: In an effort to improve the pertussis diagnosis, the Global Pertussis Initiative (GPI) proposed an algorithm of the signs/symptoms of pertussis for three age groups: 0–3 months, 4 months to 9 years, and ≥10 years of age. Methods: We evaluated the accuracy of the clinical case definitions for pertussis proposed by the GPI using laboratory-confirmed pertussis as a reference standard for four groups: clinically suspected pertussis without comorbidity; asthma exacerbation; allergic constitution, and other diagnoses (bronchitis, bronchiolitis, laryngitis, and tracheitis). We included only patients who fulfilled one or more criteria of clinical case definitions for the age groups (0–3 months, 4 months–9 years, and ≥10 years of age). The data for this prospective epidemiological study were collected between 1st January 2013–31st December 2016 at the outpatients and inpatients health care settings in the South Bačka District of Autonomous Province of Vojvodina, Serbia. We evaluated accuracy of the certain sign and symptom combinations of GPI case definitions based on their sensitivity, specificity, and likelihood ratios. Results: A total of 1043 participants were included, with 306 (29.3%) laboratory-confirmed pertussis cases. In patients aged 0–3 months, whoop and apnoea associated with laboratory confirmation of pertussis. In patients aged 4 months-9 years with a pertussis suspicion infection or with one of the other diagnoses, the highest accuracy was found for whoop combined with apnoea or post-tussive emesis. In patients aged 10 years and older, several different sign and symptom combinations were associated with an increased risk of pertussis among all enrolment diagnoses. There were fewer hospitalizations among the fully vaccinated children than in partly or unvaccinated children aged 4 months to 6 years (20.7% vs. 60.0%, p = 0.017). Conclusions: The numerous sign and symptom combinations in the observed case definitions were good predictors for laboratory-confirmed pertussis among all enrolment diagnoses, therefore suggesting the necessity for increased awareness of possibility for pertussis in patients with certain pertussis-like medical conditions. [ABSTRACT FROM AUTHOR]

Despite the importance of Bordetella avium (BA) as a respiratory pathogen of young turkeys, no infection model for the evaluation of BA-vaccine efficacy is available. The objective of this study was to evaluate the influence of route and dose of infection on the establishment of a BA-challenge model. In our first experiment, 28-day-old turkeys were either inoculated oculonasally with 105, 107 or 109 colony forming units (CFU) of BA per bird or exposed to BA by aerosol with 105-108 CFU/m3. The respiratory tract of all inoculated birds was BA-colonized, which was confirmed by choanal swabs and samples of trachea and lung, showing the highest prevalence in the aerosol-inoculated group. BA-specific humoral immune response was detected in the form of IgG in serum from five days post infection (dpi) and IgA in lacrimal fluid from seven dpi. In the second experiment, the model was tested in a vaccination trial. Twenty-one-day-old turkeys were vaccinated with a formalin-inactivated BA vaccine intramuscularly and challenged 21 days post vaccination with 107 CFU per bird oculonasally. BA-specific IgG antibodies were detected in serum and in lacrimal fluid 14 days post vaccination. As in the first experiment, secretory BA-specific antibodies of the IgA isotype were only detected in the inoculated groups from seven dpi. Despite the lack of clinical signs or pathological alterations in both experiments, vaccine efficacy was demonstrated by significant reduction in BA colonization of the trachea (P ≤ 0.05). In our study, a reliable model for BA infection has been established and has been demonstrated to be suitable for evaluation of vaccine efficacy. [ABSTRACT FROM AUTHOR]

Context • Pertussis cough (whooping cough) is distressing due to the intensity and chronicity of its cough. No specific drugs are available that can alleviate the cough’s intensity or significantly shorten its duration. Homeopathic medicines are used for a wide variety of medical conditions, including cough. Objective • The study investigated the benefits of homeopathic medicines for whooping cough, to alleviate the cough’s intensity and to shorten its duration. Design • The current study was a case series of patients with whooping cough. Setting • The study took place at one of the suburban hospital clinics of the Ann & Robert H. Lurie Children’s Hospital of Chicago (Chicago, IL, USA). Participants • Participants were 20 patients aged 21 mo to 20 y, of whom 11 were female and 18 were male, who visited the hospital clinic for treatment of the chronic cough that is characteristic of whooping cough. The details of the cases of 3 representative participants are highlighted in the text. Intervention • The 3 representative patients all received 1 dose weekly of a 30c dilution of homeopathic pertussinum and a 6c dilution of homeopathic Drosera 3 times daily. The homeopathic medicines most often used for the other participants were the same doses of pertussinum and Drosera. Outcome Measures • Verbal feedback from patient or family were obtained at the follow-up visits. Results • The intensity and duration of participant’s coughs were alleviated within days to 1 wk in most cases. Conclusions • Homeopathic medicines can alleviate the intensity or reduce the duration of whooping cough, with no adverse effects. [ABSTRACT FROM AUTHOR]

Objective To collect data of all patients admitted to hospital with a positive test to Bordetella bronchiseptica between 2001 and 2015. Methods We performed a retrospective monocentric study of all hospitalized patients over the past 15 years with a positive test to B . bronchiseptica . Results Nine patients were included between 2001 and 2015; two presented with infectious relapses, i.e. a total of 14 positive test samples were observed. Age, induced immunodeficiency, and preexisting respiratory illnesses are risk factors. All patients showed symptoms at sample collection and the infection was exclusively respiratory. The diagnosis was obtained through a cytobacteriological test of sputum, bronchial aspiration, or bronchial fibroscopy with a bronchoalveolar lavage. The drug susceptibility test revealed a natural resistance to cephalosporins including ceftazidime, monobactam, and fosfomycin. There were cases of resistance to penicillin A and to the trimethoprim/sulfamethoxazole association. The classically used antibiotic treatment for community-acquired pneumonia is based on probability and may thus fail. Four patients died. The duration and nature of the antibiotics to use have not been codified. Conclusion B . bronchiseptica infection mainly affects the elderly. All patients should be treated, regardless of the importance of the inoculum, and all infected animals should be treated. [ABSTRACT FROM AUTHOR]

We describe the detection of Bordetella holmesii as a cause of whooping cough in Spain. Prevalence was 3.9% in 2015, doubling to 8.8% in 2016. This emergence raises concern regarding the contribution of B. holmesii to the reemergence of whooping cough and the effectiveness of the pertussis vaccine. [ABSTRACT FROM AUTHOR]

Background and Objectives: Bordetella holmesii is associated with a pertussis-like respiratory syndrome in healthy individuals and also a rare cause of septicaemia, endocarditis, pneumonia, and septic arthritis, mostly in immunocompromised patients. Culture technique and real-time PCR are 2 methods used to detect Bordetella spp. Materials and Methods: In this study, 435 nasopharyngeal specimens of patients with suspected whooping cough were checked for the presence of B. holmesii using 2 methods of culture technique and real-time PCR. Results: In this study, we detected hIS1001 and IS481 of B. holmesii in 2 infants suspected of having pertussis-like syndrome. Conclusion: Our observations demonstrate that accurate diagnosis is needed to discriminate between B. holmesii and B. pertussis infections among pertussis cases; otherwise, it could lead to misestimating pertussis rate and vaccine efficacy. [ABSTRACT FROM AUTHOR]

Background: We describe the epidemiology of pertussis in Alberta, Canada by person, place, and time between 2004 and 2015, identify outbreak years, and examine vaccination coverage and vaccination timeliness.Methods: We used health data from Alberta's Communicable Disease Registry System for the period of January 1, 2004 through August 31, 2015 to identify unique cases of pertussis. Unique cases were deterministically linked to data in Alberta's immunization repository and health care insurance plan registry. Population estimates and vaccination coverage were extracted from Alberta's online Interactive Health Data Application. We estimated pertussis incidence rates per 100,000 persons by year, age group, gender, and health zone. Outbreak years were identified using a one-sided cumulative sum (CUSUM) analysis by comparing annual incidence rates to baseline rates.Results: Over the period, 3510 cases of pertussis were confirmed by laboratory testing or epidemiological linkage. Incidence rates per 100,000 persons were highest in 2004 (20.5), 2005 (13.6), and 2015 (10.4) for all age groups. Incidence rates were highest among the youngest age groups and decreased as age groups increased. Based on CUSUM analysis, 2008 and 2012 met the criteria for outbreak years. Vaccination coverage was over 90% among the general population, however only 61% of cases received at least one dose. About 60% of cases were diagnosed 5+ years after receiving the vaccine. Approximately 87-91% of vaccinated cases did not receive the first three vaccine doses in a timely manner.Conclusion: Pertussis incidence rates fluctuated over the period across all age groups. The majority of cases had no record of vaccination or were delayed in receiving vaccines. CUSUM analysis was an effective method for identifying outbreaks. [ABSTRACT FROM AUTHOR]

Changes in environmental temperature represent one of the major stresses faced by microorganisms as they affect the function of the cytoplasmic membrane. In this study, we have analyzed the thermal adaptation in two closely related respiratory pathogens Bordetella pertussis and Bordetella bronchiseptica. Although B. pertussis represents a pathogen strictly adapted to the human body temperature, B. bronchiseptica causes infection in a broad range of animals and survives also outside of the host. We applied GC-MS to determine the fatty acids of both Bordetella species grown at different temperatures and analyzed the membrane fluidity by fluorescence anisotropy measurement. In parallel, we also monitored the effect of growth temperature changes on the expression and production of several virulence factors. In response to low temperatures, B. pertussis adapted its fatty acid composition and membrane fluidity to a considerably lesser extent when compared with B. bronchiseptica. Remarkably, B. pertussis maintained the production of virulence factors at 24 °C, whereas B. bronchiseptica cells resumed the production only upon temperature upshift to 37 °C. This growth temperature-associated differential modulation of virulence factor production was linked to the phosphorylation state of transcriptional regulator BvgA. The observed differences in low-temperature adaptation between B. pertussis and B. bronchiseptica may result from selective adaptation of B. pertussis to the human host. We propose that the reduced plasticity of the B. pertussis membranes ensures sustained production of virulence factors at suboptimal temperatures and may play an important role in the transmission of the disease. [ABSTRACT FROM AUTHOR]

Bordetella holmesii can cause invasive infections but can also be isolated from the respiratory tract of patients with whooping-cough like symptoms. For the first time, we describe the lipid A structure of B. holmesii reference strain ATCC 51541 (alias NCTC12912 or CIP104394) and those of three French B. holmesii clinical isolates originating from blood (Bho1) or from respiratory samples (FR4020 and FR4101). They were investigated using chemical analyses, gas chromatography–mass spectrometry (GC–MS), and matrix-assisted laser desorption ionization–mass spectrometry (MALDI–MS). The analyses revealed a common bisphosphorylated β-(1→6)-linked d-glucosamine disaccharide with hydroxytetradecanoic acid in amide linkages. Similar to B. avium, B. hinzii and B. trematum lipids A, the hydroxytetradecanoic acid at the C-2′ position are carrying in secondary linkage a 2-hydroxytetradecanoic acid residue resulting of post-traductional biosynthesis modifications. The three clinical isolates displayed characteristic structural traits compared to the ATCC 51541 reference strain: the lipid A phosphate groups are more or less modified with glucosamine in the isolates and reference strain, but the presence of 10:0(3-OH) is only observed in the isolates. This trait was only described in B. pertussis and B. parapertussis strains, as well as in B. petrii isolates by the past. The genetic bases for most of the key structural elements of lipid A were analyzed and supported the structural data. [ABSTRACT FROM AUTHOR]

B. parapertussis is a whooping cough etiological agent with the ability to evade the immune response induced by pertussis vaccines. We previously demonstrated that in the absence of opsonic antibodies B. parapertussis hampers phagocytosis by neutrophils and macrophages and, when phagocytosed, blocks intracellular killing by interfering with phagolysosomal fusion. But neutrophils can kill and/or immobilize extracellular bacteria through non-phagocytic mechanisms such as degranulation and neutrophil extracellular traps (NETs). In this study we demonstrated that B. parapertussis also has the ability to circumvent these two neutrophil extracellular bactericidal activities. The lack of neutrophil degranulation was found dependent on the O antigen that targets the bacteria to cell lipid rafts, eventually avoiding the fusion of nascent phagosomes with specific and azurophilic granules. IgG opsonization overcame this inhibition of neutrophil degranulation. We further observed that B. parapertussis did not induce NETs release in resting neutrophils and inhibited NETs formation in response to phorbol myristate acetate (PMA) stimulation by a mechanism dependent on adenylate cyclase toxin (CyaA)-mediated inhibition of reactive oxygen species (ROS) generation. Thus, B. parapertussis modulates neutrophil bactericidal activity through two different mechanisms, one related to the lack of proper NETs-inducer stimuli and the other one related to an active inhibitory mechanism. Together with previous results these data suggest that B. parapertussis has the ability to subvert the main neutrophil bactericidal functions, inhibiting efficient clearance in non-immune hosts. [ABSTRACT FROM AUTHOR]

Bordetella bronchiseptica (B. bronchiseptica) is the most important pathogen associated with kennel cough in dogs. The presence of B. bronchiseptica in pet dogs and shelter dogs with clinical respiratory disease was investigated in present study. The genetic relatedness among the strains was determined to evaluate the role of stray dogs in spread of B. bronchiseptica to pet dogs by detection of virulence genes such as filamentous hemagglutinin (fha), pertactin (prn) and dermonecrotic toxin (dnt). We also performed the random amplified polymorphic DNA (RAPD) assay. A total of 96 B. bronchiseptica were isolated from stray and pet dogs. The fha, prn and dnt virulence genes were detected in 86, 83.3 and 61.4% strains, respectively by polymerase chain reaction (PCR) techniques. The most common genotype from stray and pet dogs was fha+prn+dnt+ as detected in 37.5% and 11.4% of all the strains, respectively. The RAPD assay showed that 3 different patterns were obtained from 96 B. bronchiseptica strains. Sixty one (63.5%) of them were clustered in one main group and then further placed in another 2 sub-groups by RAPD assay. Genetic association was seen between the B. bronchiseptica strains from stray and pet dogs. In conclusion, this study revealed that B. bronchiseptica is present at a higher rate in stray dogs than pet dogs. Stray dogs might have a significant role in the transmission of B. bronchiseptica to pet dogs. [ABSTRACT FROM AUTHOR]

Background: The genus Bordetella consists of nine species that include important respiratory pathogens such as the 'classical' species B. bronchiseptica, B. pertussis and B. parapertussis and six more distantly related and less extensively studied species. Here we analyze sequence diversity and gene content of 128 genome sequences from all nine species with focus on the evolution of virulence-associated factors. Results: Both genome-wide sequence-based and gene content-based phylogenetic trees divide the genus into three species clades. The phylogenies are congruent between species suggesting genus-wide co-evolution of sequence diversity and gene content, but less correlated within species, mainly because of strain-specific presence of many different prophages. We compared the genomes with focus on virulence-associated genes and identified multiple clade-specific, species-specific and strain-specific events of gene acquisition and gene loss, including genes encoding O-antigens, protein secretion systems and bacterial toxins. Gene loss was more frequent than gene gain throughout the evolution, and loss of hundreds of genes was associated with the origin of several species, including the recently evolved human-restricted B. pertussis and B. holmesii, B. parapertussis and the avian pathogen B. avium. Conclusions: Acquisition and loss of multiple genes drive the evolution and speciation in the genus Bordetella, including large scale gene loss associated with the origin of several species. Recent loss and functional inactivation of genes, including those encoding pertussis vaccine components and bacterial toxins, in individual strains emphasize ongoing evolution. [ABSTRACT FROM AUTHOR]

Bordetella holmesii causes both invasive and respiratory diseases in humans. Although the number of cases of pertussis-like respiratory illnesses due to B. holmesii infection has increased in the last decade worldwide, little is known about the virulence factors of the organism. Here, we analyzed a B. holmesii isolate that forms large aggregates and precipitates in suspension, and subsequently demonstrated that the autoagglutinating isolate is deficient in Bordetella intermediate protein A (BipA) and that this deletion is caused by a frame-shift mutation in the bipA gene. A BipA-deficient mutant generated by homologous recombination also exhibited the autoagglutination phenotype. Moreover, the BipA mutant adhered poorly to an abiotic surface and failed to form biofilms, as did two other B. holmesii autoagglutinating strains, ATCC 51541 and ATCC 700053, which exhibit transcriptional down-regulation of bipA gene expression, indicating that autoagglutination indirectly inhibits biofilm formation. In a mouse intranasal infection model, the BipA mutant showed significantly lower levels of initial lung colonization than did the parental strain (P < 0.01), suggesting that BipA might be a critical virulence factor in B. holmesii respiratory infection. Together, our findings suggest that BipA production plays an essential role in preventing autoagglutination and indirectly promoting biofilm formation by B. holmesii. [ABSTRACT FROM AUTHOR]

Background The use of quantitative PCR ( qPCR) for detection of Bordetella bronchiseptica in bronchoalveolar lavage fluid ( BALF) and demonstration of bacteria adhering to ciliated epithelial cells in BALF or bronchial brushing fluid ( BBF) has not been assessed in a series of affected dogs. Coinfections can worsen the clinical severity in bordetellosis, but the specific association with Mycoplasma cynos has not been evaluated. Objectives To assess the utility of culture, qPCR and cytologic examination of cytospin preparations in the diagnosis of bordetellosis in dogs and the influence of coinfection by M. cynos on disease severity. Animals Twenty-four referred dogs with B. bronchiseptica infection and 10 healthy dogs. Methods Retrospective case series. qPCR ( B. bronchiseptica and M. cynos) and culture results from BALF were recorded. Cytospin preparations from BALF and BBF were reviewed. qPCR on BALF from 10 healthy dogs were used as negative control. Results The BALF culture and qPCR detected B. bronchiseptica in 14/24 and 18/18 dogs, respectively. Coccobacilli were found adhering to ciliated epithelial cells in 20 of the 21 BALF cytologic preparations where epithelial cells were found, and 2/3 BBF cytologic preparations. Quantitative PCR detected a low level of B. bronchiseptica in one healthy dog. The frequency of detection of M. cynos was not significantly different in B. bronchiseptica (9/17 dogs) compared with healthy dogs (2/10 dogs) ( P = .09). Conclusion and Clinical Importance Quantitative PCR detection of B. bronchiseptica in BALF appears to be a useful diagnostic tool. Cytologic examination of BALF or BBF, when positive, allows a rapid and reliable diagnosis. [ABSTRACT FROM AUTHOR]

We investigated the seasonality of pertussis in Queensland, Australia, between 2008 and 2011 using notification and laboratory data. Polymerase chain reaction and serology testing data demonstrate that in the vaccine era, pertussis remains a seasonal illness, with annual peaks in summer months, and that the seasonality of notification data is masked by testing trends. [ABSTRACT FROM AUTHOR]

Pertussis specific antibodies were studied with respect to quality and quantity in a cohort of apparently healthy Egyptian children and adolescents, with their age range between 1 and 18 years, in an attempt to get a close and clear insight into the current humoral immunization status in this specified group and to try find a relation between the antibody levels and their avidities in eradication of this devastating infectious disease. Our results showed that avidity increase was most marked in young school children (6–8 years) where it seemed to reach a plateau in older children and adolescents. Antibody titer was highest in toddlers (1–2 years) and young school children (6–8 years) groups, most probably following vaccination and/or booster doses. Among children aged 1–5 years, 28% had highly avid and 50% had high titer antibodies, whereas in adolescents aged 13–18 years, 70% had highly avid antibodies and only 30% had high titer antibodies. The results clearly demonstrated that while levels of anti- Bordetella pertussis ( B. pertussis ) antibodies wane with growing age, the avidity seems to increase, to a plateau, irrespective of further antigen exposure in a pattern showing complete independence of avidity on concentration. The present study draws attention to the importance of avidity measurements, together with conventional ELISAs, for evaluating immunity against pertussis. Being based on a limited sample size, it could open doors for larger-scale surveys to be possible indicators for the need and timing of booster vaccination doses among Egyptians. [ABSTRACT FROM AUTHOR]

We report 2 cases of pulmonary Bordetella hinzii infection in immunodeficient patients. One of these rare cases demonstrated the potential transmission of the bacteria from an avian reservoir through occupational exposure and its persistence in humans. We establish bacteriologic management of these infections and suggest therapeutic options if needed. [ABSTRACT FROM AUTHOR]

Pertussis is a potentially severe respiratory disease, which affects all age groups from young infants to older adults and is responsible for an estimated 195,000 deaths occurred globally in 2008. Active research is ongoing to better understand the pathogenesis, immunology, and diagnosis of pertussis. For diagnosis, molecular assays (e.g., polymerase chain reaction) for detection of Bordetella pertussis have become more widely available and support improved outbreak detection. In children, pertussis vaccines have been incorporated into routine immunization schedules and deployed for pertussis outbreak control. Lower levels of vaccine coverage are now being observed in communities where vaccine hesitancy is rising. Additionally, recognition that newborn babies are at risk of pertussis in the USA and UK has led to recommendations to immunize pregnant women. Among adolescents and older adults in the USA, Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular pertussis (Tdap) Vaccines are recommended, but substantial individual- and system-level barriers exist that will make achieving national Healthy People 2020 targets for immunization challenging. Current antimicrobial regimens for pertussis are focused on reducing the severity of disease, reducing rates of sequelae, and minimizing transmission of infection to susceptible individuals. Continued surveillance for pertussis will be important to identify opportunities for reducing young infants' exposure and reducing the impact of outbreaks among school-aged children. Laboratory-based surveillance for newly emerging strains of B. pertussis will be important to identify strains that may evade protection elicited by currently available vaccines. Efforts to develop new-generation pertussis vaccines should be considered now in anticipation of vaccine development programs, which may require ten or more years to deliver a licensed vaccine. [ABSTRACT FROM AUTHOR]

The Type Six Secretion System (T6SS) is required for Bordetella bronchiseptica cytotoxicity, cytokine modulation, infection, and persistence. However, one-third of recently sequenced Bordetella bronchiseptica strains of the predominantly human-associated Complex IV have lost their T6SS through gene deletion or degradation. Since most human B. bronchiseptica infections occur in immunocompromised patients, we determine here whether loss of Type Six Secretion is beneficial to B. bronchiseptica during infection of immunocompromised mice. Infection of mice lacking adaptive immunity (Rag1-/- mice) with a T6SS-deficient mutant results in a hypervirulent phenotype that is characterized by high numbers of intracellular bacteria in systemic organs. In contrast, wild-type B. bronchiseptica kill their eukaryotic cellular hosts via a T6SS-dependent mechanism that prevents survival in systemic organs. High numbers of intracellular bacteria recovered from immunodeficient mice but only low numbers from wild-type mice demonstrates that B. bronchiseptica survival in an intracellular niche is limited by B and T cell responses. Understanding the nature of intracellular survival during infection, and its effects on the generation and function of the host immune response, are important to contain and control the spread of Bordetella-caused disease. [ABSTRACT FROM AUTHOR]

Despite success in expanded program immunization for an increase in vaccination coverage in the children of world, timeliness and schedule of vaccination remains as one of the challenges in public health. This study purposed to demonstrate the related factors of delayed diphtheria-tetanus-pertussis (DTP) vaccination using life table approach. A historical cohort study conducted in the poor areas of five large Iran cities. Totally, 3610 children with 24-47 months old age who had documented vaccination card were enrolled. Time of vaccination for the third dose of DTP vaccine was calculated. Life table survival was used to calculate the proportional probability of vaccination in each time. Wilcoxon test was used for the comparison proportional probability of delayed vaccination based on studies factors. The overall median delayed time for DTP3 was 38.52 days. The Wilcoxon test showed that city, nationality, education level of parents, birth order and being in rural areas are related to the high probability of delay time for DTP3 vaccination (P < 0. 001). Moreover, child gender and parent's job were not significant factors (P > 0.05). Being away from the capital, a high concentration of immigrants in the city borders with a low socioeconomic class leads to prolonged delay in DTP vaccination time. Special attention to these areas is needed to increase the levels of parental knowledge and to facilitate access to the health services care. [ABSTRACT FROM AUTHOR]

Introduction: Cough is a common indication of respiratory illness and is one of the more common symptoms of children seeking medical attention. Material and Method: We conducted a clinic-based retrospective surveillance witch analyzed the cases managed at "The National Institute for Infectious Diseases "Prof. Dr Matei Bals" - Pediatric Department, Bucharest during the period of January 2010 up to December 2014 who presented accusing cough episodes from over a week and who associated one of the following symptoms: paroxysms of coughing, inspiratory "whoop," posttussive vomiting or apnea. We selected 790 suitable cases for whom we analyzed: age, sex, vaccinal status, severity of the disease and the complications. The etiological diagnosis was made by serologic testing for Bordetella, Mycoplasma, Chlamydia, Adenovirus and by rapid testing for Sincitial Respiratory Virus (RSV). Results and findings. Based on the etiological stratification 108 patients (13,8%) were diagnosed with Bordetella Spp infections, 62,4% of them being completely unvaccinated against Pertusis, representing 11% of the national reported cases of Whooping Cough during the 5 years of survey. With decresing frequencies the rest of the cases (682) were caused by: RSV (39,7%), Adenovirus (21,5%), Mycoplasma (18,3%), Chlamydia (6,7%). The majority of the cases evolved favorable, no fatal cases were registered but 279 presented with initial altered status and required, on average, 3 days of Intensive Care Unit management. The average hospitalization period registered is 6,9 days. All the severe complications were registered in the < 6 months age group. Conclusion: Whooping cough remains endemic in Romania and Bordetells Spp. infection is associated with substantial morbidity and mortality rates among children. [ABSTRACT FROM AUTHOR]

We calculated the effectiveness of pertussis vaccine in preventing parapertussis among Oregon children 2 months to 10 years of age using 2 methods. During 2011–2016, the 2 VE methods found 66% (95% CI, 59–75%) and 82% (95% CI, 69–90%) effectiveness against parapertussis. Pertussis vaccine may induce cross-immunity. [ABSTRACT FROM AUTHOR]

Bordetella holmesii is a rare cause of invasive human disease. The fastidious and unusual nature of this organism makes routine isolation and identification challenging. We report two cases of B. holmesii bacteremia that were rapidly identified by matrix-assisted laser desorption-ionization time-of-fl ight mass spectrometry (MALDI-TOF MS) when standard techniques failed to provide speciation. There are no current standards for susceptibility testing or treatment recommendations. The rare occurrence and challenges in identifying this pathogen led us to perform a comprehensive review of the epidemiology, clinical presentations, and treatment options for this potentially invasive pathogen. [ABSTRACT FROM AUTHOR]

Highlights: [•] The composition and content of monosaccharide in TPPPS were firstly analyzed. [•] TPPPS can significantly eliminate immunosuppression and can serve as immunoregulator. [•] The pathogenicity of B. avium in chicks which co-infected with ALV-B was exacerbated. [•] TPPPS can enhance the immunity and resist to diseases in chicks. [ABSTRACT FROM AUTHOR]

Summary: Bordetella holmesii, first described in 1995, is believed to cause both invasive infections (bacteraemia, meningitis, endocarditis, pericarditis, pneumonia, and arthritis) and pertussis-like symptoms. Infection with B holmesii is frequently misidentified as being with B pertussis, the cause of whooping cough, because routine diagnostic tests for pertussis are not species-specific. In this Review, we summarise knowledge about B holmesii diagnosis and treatment, and assess research needs. Although no fatal cases of B holmesii have been reported, associated invasive infections can cause substantial morbidities, even in previously healthy individuals. Antimicrobial treatment can be problematic because B holmesii's susceptibility to macrolides (used empirically to treat B pertussis) and third-generation cephalosporins (often used to treat invasive infections) is lower than would be expected. B holmesii's adaptation to human beings is continuing, and virulence might increase, causing the need for better diagnostic assays and epidemiological surveillance. [ABSTRACT FROM AUTHOR]

To analyze pathogenicity changes of new isolate of Bordetella avium LL09 from chick embryos, 120 1-day-old specific pathogen free (SPF) chickens were intranasally inoculated with broth cultures of isolate LL09. Its colonization pattern in different chicken tissues was studied by bacterial isolation and indirect immunoenzyme histochemistry. Results showed that the bacteria were isolated from tracheas and lungs at 1 h post-infection. Afterwards, they colonized livers, hearts and spleens at 120 h and then infected kidneys at 168 h. The peak infection appeared on 21 d post-infection. They persisted in these organs and caused injuries up to 42 d. With growth of chickens, Bordetella avium began to be gradually cleared away from livers, hearts and spleens, except that it could still be detected in tracheas, lungs and kidneys until 56 d post-infection. It demonstrated that lungs and kidneys would possible be colonized for a long time by B. avium in addition to the tracheas. [ABSTRACT FROM AUTHOR]

Bordetella pertussis still poses an important health threat in developing countries. In Niger, notified pertussis cases are few despite the low diphtheria–tetanus–pertussis/pentavalent vaccine coverage. We aimed to estimate the prevalence of B. pertussis in children aged <5 years consulting at a pediatric ward. A 5-month study in 2011 recruited 342 children with respiratory symptoms at the National Hospital of Niamey. Nasopharyngeal aspirates were tested by culture and real-time polymerase chain reaction. Overall, 34 (11.2%) of the 305 available nasopharyngeal aspirates tested by real-time polymerase chain reaction were positive for a Bordetella spp., with an estimated prevalence of 8.2 cases per 1000 children aged <5. None was notified to the surveillance network. A single specimen was positive on culture. This study, the first to provide laboratory-confirmed data on pertussis in Niger, highlights the need to sensitize health care personnel to actively notify clinical cases and to integrate laboratory diagnosis in the existing surveillance system. [ABSTRACT FROM PUBLISHER]

Transmission of pathogens has been notoriously difficult to study under laboratory conditions leaving knowledge gaps regarding how bacterial factors and host immune components affect the spread of infections between hosts. We describe the development of a mouse model of transmission of a natural pathogen, Bordetella bronchiseptica, and its use to assess the impact of host immune functions. Although B. bronchiseptica transmits poorly between wild-type mice and mice lacking other immune components, it transmits efficiently between mice deficient in Toll-Like Receptor 4 (TLR4). TLR4-mutant mice were more susceptible to initial colonization, and poorly controlled pathogen growth and shedding. Heavy neutrophil infiltration distinguished TLR4-deficient responses, and neutrophil depletion did not affect respiratory CFU load, but decreased bacterial shedding. The effect of TLR4 response on transmission may explain the extensive variation in TLR4 agonist potency observed among closely related subspecies of Bordetella. This transmission model will enable mechanistic studies of how pathogens spread from one host to another, the defining feature of infectious disease. [ABSTRACT FROM AUTHOR]

Bordetella bronchiseptica infection causing atrophic rhinitis in pigs is reported from almost all countries. In the present study, occurrence of Bordetella infection in apparently healthy pigs was determined in 392 pigs sampled to collect 358 serum samples and 316 nasal swabs from Northern India by conventional bacterioscopy, detection of antigen with multiplex polymerase chain reaction (mPCR), and detection of antibodies with microagglutination test (MAT) and enzyme linked immune-sorbent assay (ELISA). Bordetella bronchiseptica could be isolated from six (1.92%) nasal swabs. Although isolates varied significantly in their antimicrobial sensitivity, they had similar plasmid profile. The genus specific and species specific amplicons were detected from 8.2% and 4.4% nasal swabs using mPCR with alc gene (genus specific) and fla gene and fim2 gene (species specific) primers, respectively. Observations revealed that there may be other bordetellae infecting pigs because about 50% of the samples positive using mPCR for genus specific amplicons failed to confirm presence of B. bronchiseptica. Of the pig sera tested with MAT and ELISA for Bordetella antibodies, 67.6% and 86.3% samples, respectively, were positive. For antigen detection mPCR was more sensitive than conventional bacterioscopy while for detection of antibodies neither of the two tests (MAT and ELISA) had specificity in relation to antigen detection. Study indicated high prevalence of infection in swine herds in Northern India. [ABSTRACT FROM AUTHOR]

Highlights: [•] We measured the protective capacities of OMVs derived from B. parapertussis (OMVsBpp). [•] We examined the cross protective capacities of OMVsBpp. [•] Cross protection against B. pertussis was observed. [•] Commercial aP vaccines offer little protection against B. parapertussis. [•] Vaccines containing OMVsBpp are safety. [Copyright &y& Elsevier]

Bordetella holmesii is an emerging opportunistic pathogen that causes respiratory disease in healthy individuals and invasive infections among patients lacking splenic function. We used 16S rRNA gene analysis to confirm B. holmesii as the cause of bacteremia in a child with sickle cell disease. Semiconductor-based draft genome sequencing provided insight into B. holmesii phylogeny and potential virulence mechanisms and also identified a toluene-4-monoxygenase locus unique among bordetellae. [ABSTRACT FROM AUTHOR]

Bordetella pertussis isolates that do not express pertactin (PRN) are increasing in regions where acellular pertussis vaccines have been used for >7 years. We analyzed data from France and compared clinical symptoms among infants <6 months old infected by PRN-positive or PRN-negative isolates. No major clinical differences were found between the 2 groups. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18: E340-E346 Abstract Bordetella pertussis and Bordetella parapertussis are closely related bacterial agents of whooping cough. Whole-cell pertussis (wP) vaccine was introduced in France in 1959. Acellular pertussis (aP) vaccine was introduced in 1998 as an adolescent booster and was rapidly generalized to the whole population, changing herd immunity by specifically targeting the virulence of the bacteria. We performed a temporal analysis of all French B. pertussis and B. parapertussis isolates collected since 2000 under aP vaccine pressure, using pulsed-field gel electrophoresis (PFGE), genotyping and detection of expression of virulence factors. Particular isolates were selected according to their different phenotype and PFGE type and their characteristics were analysed using the murine model of respiratory infection and in vitro cell cytotoxic assay. Since the introduction of the aP vaccines there has been a steady increase in the number of B. pertussis and B. parapertussis isolates collected that are lacking expression of pertactin. These isolates seem to be as virulent as those expressing all virulence factors according to animal and cellular models of infection. Whereas wP vaccine-induced immunity led to a monomorphic population of B. pertussis, aP vaccine-induced immunity enabled the number of circulating B. pertussis and B. parapertussis isolates not expressing virulence factors to increase, sustaining our previous hypothesis. [ABSTRACT FROM AUTHOR]

The author reflects on issues about pertussis, which is a vaccine-preventable respiratory disease caused by Bordetella pertussis, around the world as of mid-September 2012. She focuses on studies on airborne transmission of the disease, particularly in animal models. She cites the move at Merkel laboratory to use the nonhuman primate, Papio anubis or the olive baboon, in its study.

The article reports on the diagnosis of whooping cough in microarray format.

Objective To assess the incidence of pertussis (whooping cough) in subjects aged 50 years and older in France. Methods Participating family physicians (FPs) using the patient record management software AxiSanté ® included patients aged 50 years and older, who had signed an informed consent form, presenting with persistent cough for 7 to 21 days. Bordetella genetic material was detected by polymerase chain reaction (PCR) on nasopharyngeal samples collected at the FP's discretion. Results A total of 42 FPs included 129 patients from June 2013 to August 2014 (large cities: 38; medium-sized cities: 57; rural areas: 34); 106 samples were analyzed. Overall, 30 pertussis cases were diagnosed: 10 cases confirmed by PCR, 18 purely clinical cases, and two direct epidemiological cases. The crude incidence rate per 100,000 patients aged ≥ 50 years was 103.6 (95% CI: 69.9–47.9): 77.1 in large cities, 103.1 in medium-sized cities, and 143.9 in rural areas. The extrapolated incidence rate per 100,000 persons aged ≥ 50 years was 187.1 (95% CI: 126.2–67.1): 131.1 in large cities, 256.1 in medium-sized cities, and 242.2 in rural areas. Conclusion The population aged 50 years and older can serve as a reservoir. Its role in Bordetella pertussis circulation should be taken into account for pertussis booster vaccination programs. [ABSTRACT FROM AUTHOR]

Introduction In 2005, in Finland, the whole-cell pertussis vaccine was replaced by acellular given at 3–5–12 months, and boosters at 4 and 11–15 years of age. From July 2012, military conscripts have been offered a pertussis booster dose. Conscription is mandatory for Finnish men, and >95% were 19–21 years old when enrolled during 2012–2015. We describe the epidemiology of pertussis in Finland during 1995–2015, and show the indirect effect of the booster in conscripts on pertussis incidence in the Finnish population. Materials and methods We extracted data on laboratory confirmed notified pertussis cases from the National Infectious Diseases Register. We calculated annual incidence using as denominator population data and incidence rate ratios (IRR) using Poisson regression. Results The overall pertussis incidence peaked in 2004 (31/100,000) and was lowest in 2015 (3.0/100,000), with 66 reported cases in <3 months infants in 2004 versus 6 in 2015. The majority of the cases were female (59%) with a male-to-female case ratio of 1:1.5. Cases were spread throughout the year with highest incidence during August-February. Among the 19- to 21-year-olds in the general population, incidence decreased from 49/100,000 in 2011 to 0.51/100,000 in 2015 (IRR = 0.01; 95%CI, 0.00–0.16). Among the same age group, comparing the 3.5-year period before and after July 2012, incidence decreased from 33/100,000 to 5.3/100,000 (IRR = 0.16; 95%CI, 0.06–0.40) in males and from 16/100,000 to 5.0/100,000 (IRR = 0.31; 95%CI, 0.11–0.84) in females. Conclusions Implementation of the pertussis booster dose in Finnish military conscripts was followed by a significant decrease in pertussis incidence both among the 19- to 21-year-old males and females, possibly reflecting herd immunity effect. Together with booster doses in adolescents this has resulted in low incidence in the whole population including infants. Our results support the implementation of the booster dose for conscripts. We recommend continuing monitoring pertussis epidemiology to optimize pertussis vaccination strategies in Finland. [ABSTRACT FROM AUTHOR]

Background and Aims Pertussis is a common and potentially serious disease affecting mainly infants and young children. In its non-classic presentation, pertussis can be clinically indistinguishable from other respiratory illnesses. Pertussis today often remains underdiagnosed in adults. Our aims was to report a complicated cases of pertussis. Results A case of serologically confirmed pertussis occurred in an 18-year-old man presenting with pneumomediastinum, subcutaneous emphysema in the neck and chest, and persistent attacks of coughing with apnea that required treatment in the intensive care unit. Conclusion Pneumomediastinum and subcutaneous emphysema have never been described in adult patients with pertussis. Physicians should be aware that patients presenting with persistent cough and pneumomediastinum may have pertussis and include this in their differential diagnosis. [ABSTRACT FROM AUTHOR]

Bordetellosis, caused by Bordetella avium , continues to be an economic problem in the poultry industry of China. Vaccines with good protective ability are lacking. Thus, developing a novel vaccine against the B. avium infection is crucial. Here, we constructed a recombinant Pichia pastoris transformant capable of expressing the outer membrane protein A (ompA) of B. avium to prepare the recombinant ompA subunit vaccine and then evaluated its immune effects. To further investigate the immunomodulation effects of Taishan Pinus massoniana pollen polysaccharides (TPPPS) on this subunit vaccine, three concentrations (20, 40, and 60 mg/mL) of TPPPS were used as the adjuvants of the ompA subunit vaccine respectively. The conventional Freund's incomplete adjuvant served as the control of TPPPS. Chickens in different groups were separately vaccinated with these vaccines thrice. During the monitoring period, serum antibody titers, concentrations of serum IL-4, percentages of CD4 + and CD8 + T-lymphocytes in the peripheral blood, lymphocyte transformation rate, and protection rate were detected. Results showed that the pure ompA vaccine induced the production of anti-ompA antibody, the secretion of IL-4, the increase of CD4 + T-lymphocytes counts and lymphocyte transformation rate in the peripheral blood. Moreover, the pure ompA vaccine provided a protection rate of 71.67% after the B. avium challenge. Notably, TPPPS adjuvant vaccines induced higher levels of immune responses than the pure ompA vaccine, and 60 mg/mL TPPPS adjuvant vaccine showed optimal immune effects and had a 91.67% protection rate. Our findings indicated that this recombinant B. avium ompA subunit vaccine combined with TPPPS had high immunostimulatory potential. Results provided a new perspective for B. avium subunit vaccine research. [ABSTRACT FROM AUTHOR]

Multiplex polymerase chain reaction (PCR) tests are useful for the rapid detection of pathogens, though diagnostic challenges may arise. We report 2 immunocompromised patients with Bordetella bronchiseptica respiratory infection misdiagnosed as Bordetella pertussis using PCR, including discussion of transmission, diagnostic testing, clinical implications, and infection control considerations. [ABSTRACT FROM AUTHOR]

Bordetella pertussis causes whooping cough, an infectious disease of the respiratory tract that is re-emerging despite high vaccine coverage. Here we examined the role of Toll-like receptor (TLR) adapter protein Mal in the control of B. pertussis infection in the lungs. We found that B. pertussis bacterial load in the lungs of Mal-defective (Mal−/−) mice exceeded that of wild-type (WT) mice by up to 100-fold and bacteria disseminated to the liver in Mal−/− mice and 50% of these mice died from the infection. Macrophages from Mal−/− mice were defective in an early burst of pro-inflammatory cytokine production and in their ability to kill or constrain intracellular growth of B. pertussis. Importantly, the B. pertussis bacterial load in the lungs inversely correlated with the number of alveolar macrophages. Despite the maintenance and expansion of other cell populations, alveolar macrophages were completely depleted from the lungs of infected Mal−/− mice, but not from infected WT mice. Our findings define for the first time a role for a microbial pattern-recognition pathway in the survival of alveolar macrophages and uncover a mechanism of macrophage-mediated immunity to B. pertussis in which Mal controls intracellular survival and dissemination of bacteria from the lungs. [ABSTRACT FROM AUTHOR]

The article describes the medical case of a 16-year-old boy who was admitted to the Massachusetts General Hospital for coughing spells. It notes that the patient had persistent cough and nasal congestion for 3 weeks prior to his admission in the emergency department. The diagnosis revealed that the boy may have suffered from pertussis despite having received tetanus toxoid-reduced diphtheria toxoid-acellular pertussis (Tdap) booster vaccine at 11 years old.

Acellular vaccines against Bordetella pertussis were introduced in Australia in 1997. By 2000, these vaccines had replaced whole-cell vaccines. During 2008-2012, a large outbreak of pertussis occurred. During this period, 30% (96/320) of B. pertussis isolates did not express the vaccine antigen pertactin (Prn). Multiple mechanisms of Prn inactivation were documented, including IS481 and IS1002 disruptions, a variation within a homopolymeric tract, and deletion of the prn gene. The mechanism of lack of expression of Prn in 16 (17%) isolates could not be determined at the sequence level. These findings suggest that B. pertussis not expressing Prn arose independently multiple times since 2008, rather than by expansion of a single Prn-negative clone. All but 1 isolate had ptxA1, prn2, and ptxP3, the alleles representative of currently circulating strains in Australia. This pattern is consistent with continuing evolution of B. pertussis in response to vaccine selection pressure. [ABSTRACT FROM AUTHOR]

Background. Pertussis continues to be a public health concern around the world because of increasing morbidity among vaccinated children and adults, severe disease forms in infants and late diagnosis. It is frequently believed that pertussis is exclusively a "childhood disease", but there have been increasing reports of B. pertussis infection among adolescents and adults, although the peak incidence and the highest mortality occur among infants. Case presentation. 7-week-old infant illness started with a dry cough, on the 8th day of her illness it became paroxysmal. The infant's recurrent apnea episodes started on the day 12 of the illness, she started vomiting and developed severe respiratory failure. The patient required intubation and ventilation and stayed in PICU for 9 days. Blood showed lymphocytic leukocytosis. Pertussis diagnosis was confirmed by specific IgM antibody seroconversion. Disease to her 30-year-old mother began with catarrhal symptoms, later her paroxysmal coughing became accompanied by vomiting. Atypical bacterial bronchitis was suspected. Rigorous epidemiological history and detection of pertussis antibodies have helped to the confirmation of the pertussis diagnosis. The clinical course of B. pertussis infection in the infant was severe, and the mother's course was mild. Conclusions. Our presented clinical case of the infant and her mother's B. pertussis infection illustrates the complex diagnostic difficulties in diagnosing pertussis, requiring laboratory confirmation, analysis of epidemiological data and appropriate evaluation. Pertussis to the infant and the mother occurred with the typical three stages: catarrhal, paroxysmal and convalescente. The infant underwent a severe form of the disease, but the outcome was good. Understanding the source of pertussis may provide new approaches to preventing pertussis in the most vulnerable infants. Ivadas. Del didejancio vakcinuotu nuo kokliušo vaiku bei suaugusiu žmoniu sergamumo, sunkiu kudikiu ligos formu, velyvos diagnostikos kokliušas išlieka viena svarbiausiu visuomenes sveikatos apsaugos problemu visame pasaulyje. Nors neretai manoma, kad kokliušas yra išimtinai vaiku liga, taciau pranešimai rodo, kad dideja paaugliu ir suaugusiuju sergamumas kokliušu. Klinikinis atvejis. Septyniu savaiciu kudikio liga prasidejo sausu kosuliu, kuris veliau tapo priepuoliniu. Dvylikta ligos diena prasidejo apneja, vemimas, triko kvepavimas. Paciente buvo intubuota, taikyta dirbtine plauciu ventiliacija. Ji buvo gydyta intensyviosios terapijos skyriuje 9 dienas. Atlikus bendraji kraujo tyrima buvo nustatyta limfocitine leukocitoze. Kokliušo diagnoze buvo patvirtinta specifiniu IgM antikunu serokonversija. Trisdešimties metu motinos liga prasidejo nedideliais katariniais simptomais, veliau atsirado priepuolinis kosulys, kuris pasibaigdavo vemimu. Buvo itartas netipiniu bakteriju sukeltas bronchitas. Detali epidemiologine anamneze ir kokliušo antikunu aptikimas patvirtino kokliušo diagnoze. Kudikis kokliušu sirgo labai sunkiai, o motina - lengvai. Išvados. Musu pateiktas kudikio ir motinos kokliušo klinikinis atvejis atskleide diagnostikos sunkumus, epidemiologiniu duomenu bei laboratoriniu tyrimu svarba. Kudikio ir motinos kokliušas buvo tipines formos su trimis ligos stadijomis (katarine, kosulio priepuoliu ir sveikimo). Kudikis kokliušu sirgo labai sunkiai, o motina - lengvai. Gilesnes žinios apie kokliuša gali suteikti nauja požiuri i kudikiu, kaip labiausiai pažeidžiamu asmenu, apsauga. [ABSTRACT FROM AUTHOR]