1. WHOOPING COUGH Presentation: @ Nasal discharge, pyrexia @ Paroxysmal cough. @ Respiratory distress, apnoea @ Pneumonia

3. Causes of whooping cough: @ Bordetella species @ Viruses: Respiratory syncytial virus, parainfluenza virus, adenovirus @ Mycoplasma pneumoniae. BORDETELLA @ Gram negative rods, non-motile, aerobic, catalase positive, oxidase positive, capsulated.

5. Bordetella Species: @ B. pertusssis: Severe whooping cough. @ B. parapertusis: Mild whooping cough. @ B. bronchiseptica: Wound infections. Pathogensis: @ Organism attaches to URT cilia, leading to decreased activity of cilia. @ Pertusssis toxin damages these cilia.

7. Laboratory Diagnosis of Bordetella: Specimens: @ Nasopharyngeal secretions collected by: # Pernasal swabs # Aspiration # Cough plates. Microscopy: @ Small, cocco-bacilli, Gram negative, capsulated, non-motile.

9. Culture: @ Inoculate Bordet-Gengou medium, containing 20-30% blood. @ Inoculate the selective medium charcoal cephalexin blood agar (CCBA). @ Incubate up to 6 days at 37°C in moist aerobic atmosphere. @ Charcoal medium: Colonies small, shiny @ Bordet-Gengou : Colonies haemolytic and mucoid

11. Identification: @ Slide agglutination tests using specific antisera. @ Fluorescent antibody staining. Epidemiology: @ B. pertusssis infects Man only. @ Transmission: By air-borne droplets. affecting infants and young children.

13. Vaccination: @ Killed vaccine, adsorbed to an adjuvant (aluminum hydroxide). @ Acellular vaccine, a purified protein of the organism @ Given as part the triple vaccine (DTP), in 3 doses. Booster doses are given at 12-15 months and on entering school. @ Killed vaccine, Not recommended: cause encephalopathy. The acellular vaccine is the one to use.