Whooping cough, the resurgence of a vaccine preventable disease

Pertussis disease, otherwise referred to as whooping cough or the ‘100-day cough’ is caused by members of the Bordetella spp. There are currently 16 members of the species and 12 that have been known to cause human infection: B. pertussis, B. parapertussis, B. bronchiseptica, B. avium, B. hinzii, B. holmesii, B. trematum, B. ansorpii, B. petrii, B. broncialis, B. flabilis, and
B. sputigena. Of these, B. pertussis and B. parapertussis are known to be the causative organisms of whooping cough, with the latter causing a milder form of the disease.¹ These bacteria are small aerobic Gram-negative coccobacilli usually seen singularly or in pairs on Gram staining.² They are transmitted via airborne droplets, are highly contagious and considered more transmissible than SARS-CoV-2.³ Incubation periods are usually around 7-10 days but can be as much as 20 days, and the patient remains infectious for up to five weeks.¹ Diagnosis is often difficult as pertussis disease is initially not unlike common viral upper respiratory tract infections (URT) and sometimes can present atypically.⁴ Moreover, the organism is fastidious, slow growing and requires specialist selective media.² Bordetella spp. are hazard group 2 organisms;⁵ however, with clinical samples coming from the lower respiratory tract Mycobacterium tuberculosis, a hazard group 3 organism needs to be considered. 

History

There have been a number of different names associated with pertussis disease including those from the Anglo-Saxon word ‘hwostana’ meaning cough,⁶ through ‘chincough’,⁷ to the commonly used term whooping cough⁴ and more recently to 100-day cough as frequently used by the press.⁸