Return of the Whoop 2021 (student)

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Return of the Whoop! The Resurgence of Pertussis Modified by Dr Elaine Beaulieu from a Case Study created by Lynn B. DeSanto , Department of Science, Lackawanna College, Scranton, PA, USA. This copyrighted material cannot be distributed or shared outside of this class. Assignment Instructions This is a home assignment. Home assignments replace face to face classes. If you need help for your home assignment, please ask your friends or myself, I am always there for my students. You can take an online appointment to see me by clicking the following link: https://calendly.com/elaine- beaulieu/15min o You may work in teams, if you do, identify your partners below. o You must answer all questions , or your assignment will not be graded. o The completed assignment must be submitted in a pdf format. o You must hand in your written assignment by downloading the completed assignment on Brightspace. o Your home assignment is worth 30 points of your homework mark. o You will need to watch the following video and answer the following questions pertaining to the videos to complete the assignment. o All questions must be answered for the assignment to be marked. o Only a few questions will be marked , you don’t know which one. The answers to all questions will be given to you after everyone has submitted their assignment, so you can compare your answers to that expected by the professor. The following team members collaborated on this assignment. Although we have worked together, each member has written their answers in their own words. Estimated time: 2h

Team member name Student ID Monessa Pierre 300205112 Part 1 - The history of whooping cough The year was 1893, and Pearl Kendrick was a young girl growing up in Wheaton, Illinois, when she contracted “whooping cough.” Whooping cough, or pertussis, as it is sometimes called, is an illness that dates back to the year 1540. The first epidemic was documented in France in 1578. It is a respiratory illness that is transmitted from one person to another through aerosol droplets. The illness begins as a mild respiratory infection, progresses to a cough, develops into paroxysms of cough (whoop) before symptoms finally wane over weeks to months (duration typically 6–10 weeks). Watch the following short video on whooping cough infections: (Whooping cough - Mayo Clinic , Watch on YouTube, 10:43min) Pearl Kendrick was one of the lucky survivors. She recovered completely from an illness that during the early 1900s claimed more lives than measles, scarlet fever, tuberculosis, diphtheria, and polio combined. Pearl never forgot the illness (Shapiro-Shapin, 2010). 2

Although a continent away, she followed with great interest the news of two French scientists, Jules Bordet and Octave Gengou, and their work isolating the microbe that causes the “whooping cough,” Bordetella pertussis. Pearl developed as a woman, a scientist, and a researcher. She ultimately began her own study into the organism, Bordetella pertussis. She studied the disease of pertussis. She remembered how you could feel fine with only sneezing, low fever, and slight cough, and then within several days you would begin “whooping” and be unable to take in any air. In the year 1943, over 40 years later, Pearl with the help of her partner, Grace Eldering, formulated the first vaccine to combat Bordetella pertussis. This was accomplished while Pearl Kendrick was the director of the Western Michigan Branch Laboratory in Grand Rapids, Michigan. Massive vaccination implementation decreased the cases of pertussis more that 80% of what they had been in the pre-vaccine era (Garrett, 2006). Refer to Figure 1 and fast forward to the 90’s when the cases of pertussis had more than tripled since the 1980s. In 2012 and 2015, more than 4,500 and 3,500 cases were reported respectively to Health Canada. So why is this vaccine preventable disease on the rise (seems to be cyclical)? Figure 1. Number and incidence rate (per 100,000 population) of reported pertussis cases in Canada by year, 1938 to 2015. Source: Health Canada, Vaccine preventable disease - Surveillance report to December 31, 2015 ) Questions: 1. Provide a description for whooping cough. Include symptoms, mechanism, duration, and recovery in your description. (You can find this information in Chapter 22.2 of the free microbiology textbook from Rice University) (10 points) 3

Whooping cough is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. a bacterial infection that’s contracted via respiratory droplets or direct contact discharged secreted from infected mucus membrane. Once inhaled, the bacteria enters the incubation phase, they attach to the cilia lining the respiratory tract, particularly in the upper respiratory system . Bordetella pertussis produces various toxins, including pertussis toxin, which plays a crucial role in the infection process. Pertussis toxin interferes with the normal functioning of the host's immune system. It inhibits the clearance of mucus from the respiratory tract and suppresses the immune response, making it easier for the bacteria to survive and multiply. This illness usually last 6–10 weeks. Following the incubation stage the bacterium progresses to the catarrhal phase. This stage resembles a common cold, with symptoms such as a runny nose, sneezing, mild cough, and a low-grade fever. During this stage, the person is contagious, and the bacteria continue to multiply, this lasts about 2 weeks. The following is the paroxysmal stage, which is characterized by severe and prolonged coughing fits, often with the distinctive whooping sound when trying to inhale after a coughing episode. This stage can last for several weeks(1-6 weeks) and is associated with intense coughing spells, sometimes leading to vomiting, exhaustion, and other complications. After the paroxysmal stage, the frequency and severity of coughing gradually decrease. The convalescent stage marks the recovery phase, during which the individual may still experience occasional coughing but is no longer as contagious. Recovery from whooping cough can be slow, and lingering coughing may persist for several weeks to months, even after the acute symptoms have subsided. During this convalescent period, individuals may gradually regain their strength and overall well-being, commonly lasting 2-3 weeks. Starts with Incubation period, time between the bacterium entering the body and the onset of symptoms this last about a week. When the bacterium beings to multiply damage to the respiratory track causes symptoms like nasal congestion cough and may cause a fever, this is known as the catarrhal phase and lasts about 2 weeks. This stage is very contagious because their presence in the respiratory tract makes it easy to aerosolize. This is followed by the paroxysmal phase which lasts 1-6 weeks, symptoms persist despite the immune system is killing and clearing Bordetella during this time distinguished by the other phase by distinct paroxysms that sounds similar to uninterrupted machine gun bursts and a inspiratory whooping noise. The next phase is the convalescent phase that lasts 2-3 weeks. During this time the cough gradually improves paroxysms and whooping fade away and the air way heals. Part 2 – The cause of whooping cough As shown in Figure 2, Bordetella pertussis is a very small Gram-negative rod. It was first isolated and described in 1909 by Jules Bordet and Octave 4

Gengou in Paris. It is a strict aerobe and grows at 35–37 degrees Celsius. The supplemental media used to grow this organism in the laboratory is Bordet-Gengou Media, named after the two scientists credited with discovering the Bordetella pertussis bacteria. The media is made up of the following components:  Potato infusion —source of carbon and nitrogen.  Peptic digest from animal tissue —source of carbon and nitrogen.  Glycerol —source of added nutrients.  Sheep blood (15%)—source of added nutrients and provides for possibility of hemolysis.  Sodium chloride —maintains osmotic pressure.  Agar —provides support for growth. Bordetella pertussis colonies appear smooth, raised, and glistening, with a zone of hemolysis (Becton, Dickinson and Company, 2003). Identification of the organism can then be confirmed through biochemical tests, polymerase chain reaction (PCR), direct fluorescent antibody (DFA), and serologic tests. Pathogenicity Watch the following video on the mechanisms of pathogenesis for B. pertussis . The video is only relevant for this part up to the 3:46min mark. (Pertussis (Whooping cough) - by Osmosis Study Video , Watch on YouTube , 8:39min) The organism has three major virulence factors for pathogenicity: toxins, hemolysins, and adhesins. These antigenic and disease stimulating components are:  Pertussis toxin (PT)—disruption of phagocytic activity.  Filamentous hemagglutinin (FHA)—adherence to ciliated cells.  Adenylate cyclase—reduction of phagocytic activity and initiation of infection. 5 Figure 2. Gram Stain of Bordetella pertussis (gram negative rods 0.2 × 0.5 – 2.0 ums). (Source: CDC, image #2121, p.d.)

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