Prevention and Treatment

Intensive vaccination of infants with killed B. pertussis cells can prevent the disease in about 70% of individuals. Its widespread administration to young children is responsible for the drop from 235,239 reported cases of pertussis in the United States in 1934 to only about 1,000 in 1981. Since then, reported cases have generally ranged from 2,000 to 8,000 per year (figure 23.15).

Pertussis vaccine is given along with diphtheria and tetanus toxoids ("DPT") by injection at 6 weeks, and 4, 6, and 18 months of age, with a booster dose between 4 and 6 years. Common reactions to the vaccine include pain and tenderness at the injection site and fever, occasionally high enough to cause convulsions. Acellular vaccines that use only part of the bacterium instead of the whole cells, first approved for use in the United States in 1991, are now advised for all five doses and give as good or better immunity with fewer side effects. Erythromycin given for treatment reduces the duration of symptoms if given early in the disease, and the antibiotic usually eliminates B. pertussis from the respiratory secretions. ■ acellular vaccines, p. 423

The main features of this disease are shown in table 23.8.

Tuberculosis

Over the last hundred or more years, tuberculosis gradually declined in industrialized countries in association with improved living standards. In 1985, however, the rate of decline slowed,

Nester-Anderson-Roberts: I IV. Infectious Diseases I 23. Respiratory System I I © The McGraw-Hill

Microbiology, A Human Infections Companies, 2003

Perspective, Fourth Edition

Ptx toxin

Ptx toxin

Membrane of host cell

Ptx toxin binds to the host cell surface using the B subunits.

Ptx toxin binds to the host cell surface using the B subunits.

The A portion of Ptx is activated when transferred into the host cell.

The A portion of Ptx is activated when transferred into the host cell.

The G protein is inactivated by ADP ribosylation.

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