From the Guidelines
Yes, the presence of Bordetella pertussis in the human respiratory tract is considered an infection. This bacterium causes pertussis, commonly known as whooping cough, which is a highly contagious respiratory disease 1. When B. pertussis enters the respiratory system, it attaches to the cilia of respiratory epithelial cells and produces toxins that damage these cells and cause inflammation. The infection typically progresses through three stages: catarrhal (cold-like symptoms), paroxysmal (severe coughing fits), and convalescent (gradual recovery).
Key Points
- Treatment usually involves antibiotics such as azithromycin (500 mg on day 1, then 250 mg daily for 4 more days), clarithromycin (500 mg twice daily for 7 days), or erythromycin (500 mg four times daily for 14 days) 1.
- Early antibiotic treatment is crucial to reduce symptoms and prevent transmission, though antibiotics may have limited effect once the paroxysmal stage begins.
- Pertussis can be particularly dangerous for infants and young children, potentially causing serious complications including pneumonia, seizures, brain damage, and death.
- Prevention through vaccination remains the most effective strategy against this infection 1.
Diagnosis and Prevention
Diagnosis of pertussis infection can be made through detection of the organism from nasopharynx secretions, PCR, or serologic tests 1. Prevention through vaccination is the most effective strategy against pertussis, with vaccines available for children and adults 1. Maintaining high vaccination coverage rates and minimizing exposures of infants and persons at high risk for pertussis is crucial to prevent the disease 1.
Treatment Recommendations
The most recent and highest quality study recommends treatment with erythromycin or newer macrolides such as clarithromycin and azithromycin 1. These antibiotics can rapidly clear B. pertussis from the nasopharynx and decrease the coughing paroxysms and other complications. Patients with active cases should be isolated at home and away from work or school for 5 days after therapy with antibiotics is started.
From the FDA Drug Label
Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals, rendering them noninfectious
- The presence of Bordetella pertussis is considered an infection, as erythromycin is indicated for the treatment of pertussis (whooping cough) caused by this organism 2.
- Infection is implied by the need for antibacterial therapy, such as erythromycin, to treat the condition.
From the Research
Definition of Infection
- The presence of Bordetella (B) pertussis is typically considered an infection, as it is a bacterial pathogen that can cause disease in humans 3, 4, 5, 6, 7.
Characteristics of B. pertussis Infection
- B. pertussis infection can be confirmed by culture, serology, or polymerase chain reaction (PCR) 4, 5, 6, 7.
- The presence of B. pertussis in the nasopharynx is a key indicator of infection, and antibiotics such as erythromycin, azithromycin, and clarithromycin can be effective in eliminating the bacteria from the nasopharynx 3, 4, 5, 7.
Clinical Implications
- The presence of B. pertussis can cause a range of symptoms, from mild cough to severe pertussis, and can be a significant public health concern, particularly in vulnerable populations such as infants and young children 4, 5, 6, 7.
- Antibiotic treatment can help reduce the transmission of B. pertussis and prevent complications, but it may not alter the clinical course of the illness 3, 4, 5, 7.