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This book aims to serve as the complete reference on Bordetella pertussis, which has made a resurgence in recent years. Included in its scope are the following topics: ú Discussion of all aspects of pertussis resurgence and the discovery of pertussis in adults ú Pathology and clinical manifestations ú The development of new diagnostic methods and treatments ú Concern about reactogenicity of DTwP vaccines ú The development, testing, and licensure of DTaP and Tdap vaccines ú The demonstration of why DTaP vaccines fail ú Progress in the understanding of the epidemiology of B. pertussis infection ú Progress in the understanding of the cause of death and its prevention in infants Whooping Cough Due to Bordetella pertussis and Other Bordetella Subspecies aims to fill the gap in current information, and detail all recent advances in the understanding and treatment of this serious illness.

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INTRODUCTION HISTORY PHYLOGENETIC RELATIONSHIPS BETWEEN BORDETELLA SUBSPECIEIS VIRULENCE DETERMINANTS AND MOLECULAR PATHOGENESIS Animal Models and humans Virulence Determinants Filamentous hemagglutinin Agglutinogens Fimbriae Pertactin and other autotransporters Adenylate cyclase Dermonecrotic toxin Lipopolysaccharides Type III secretion system Tracheal cytotoxin Pertussis toxin Other: All other proteins and polysaccharides (capsule) will also be presented as possible virulence determinants. PATHOLOGY B. pertussis Infection B. bronchiseptica Infection PATHOGENESIS AND IMMUNITY CLINICAL MANIFESTATIONS B. pertussis Classic illness Mild illness and asymptomatic infection Infants Adults B. parapertussis B. bronchiseptica B. holmesii DIAGNOSIS Differential Diagnosis of Bordetella Infections Specific Diagnosis of B. pertussis Infections Culture of B. pertussis Detection of B. pertussis by PCR Serologic diagnosis of B. pertussis Infection TREATMENT VACCINATION AND PREVENTION B. pertussis Vaccines Whole-cell DTP vaccines (i) Reactogenicity (ii) Vaccine efficacy Acellular pertussis component DTP vaccines (i) Reactogenicity (ii) Vaccine efficacy Possible new vaccines EPIDEMIOLOGY: IMPLICATIONS FOR THE CONTROL OF HUMAN INFECTIONS B. pertussis Epidemiology Observed (reported pertussis) (i) Incidence (ii) Mortality (iii) Sex and race (iv) Season and geographic areas B. pertussis infection (i) Percentage of cough illnesses due to B. pertussis in adolescents and adults (ii) Rate of B. pertussis infections (iii) Rate of cough illnesses due to B. pertussis infections B. parapertussis Epidemiology Incidence and mortality Sex, race, season, and geographic areas Interrelationship between B. parapertussis and B. pertussis infections B. bronchiseptica Epidemiology B. holmesii Epidemiology LONG-TERM GOALS OF PERTUSSIS PREVENTION Eradication of B. pertussis Circulation Lesser Goals FUTURE RESEARCH Pathogenesis of disease Better Vaccines More Complete Epidemiologic Study REFERENCES

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