Whooping cough

Whooping cough, also called pertussis, is an infectious disease caused by the Gram-negative bacteria Bordetella pertussis (Kilgore, Salim, Zervos, & Schmitt, 2016). Bordetella species are classified within the Alcaligenaceae family and comprise ten genetically different species (Kilgore et al., 2016). B. pertussis is considered as the sole causative agent of pertussis, however, species such as B. parapertussis and B. holmesii can cause disease-like signs and symptoms (Kilgore et al., 2016). B. pertussis and B. holmesii are specific pathogens for humans, but B. parapertussis can infect domestic animals such as sheep and pigs. B. bronchiseptica has been described as a species that infects immunocompromised people and also infects animals such as dogs, cats and pigs (Kilgore et al., 2016).

In children under one year of age, pertussis has a significant morbi-mortality, and the clinical picture is less severe in adolescents and adults, sometimes it is asymptomatically, especially in those who have been vaccinated against pertussis (Domenech de Cellès et al., 2016; WHO, 2017b).

Various outbreaks of pertussis have been registered in several Mexican states. In 2016, an outbreak of the disease was reported in Baja California, where the index case was a girl who was one month old. Subsequently, 26 people with symptoms of the disease were identified, of which four were diagnosed with B. pertussis and three with B. holmesii (Franco-Esquivel, De La Paz, & Siqueiros-Ramírez, 2018). In 2017, two children were diagnosed with whooping cough in Guanajuato; one of them (eight months old) died (However, 2017). In both cases, the children did not have the vaccine. The children were children of Mixtec day laborers from Guerrero.

Outbreaks of possible cases of pertussis have been reported in Chiapas at different municipalities in different years (San Juan Cancuc, 2007; Yajalón, 2013; and Villaflores, 2015). However, one region is particular important to follow the epidemiological situation of pertussis. The Highlands region of Chiapas is characterized is a highly-marginalized region; poor social, economic, educational, and health indicators are met. All these factors contribute to the emergence and prevalence of preventable diseases such as pertussis (Sánchez-Pérez, Arana-Cedeño, Ely-Yamin, & Ford, 2006). The epidemiological situation of whooping cough in the Highlands region is unknown because there is sub-diagnosis and sub-registration of the disease.

On 2019, we began the study “Epidemiological and molecular analysis of Bordetella pertussis in children admitted to the Hospital de las Culturas de San Cristóbal de Las Casas, Chiapas”. Its main objective is to analyze the epidemiological situation of pertussis and to collect circulating strains of Bordetella pertussis in patients with clinical suspicion of whooping cough from the Highlands region of Chiapas, as well as to characterize the isolates, both phenotypically and genotypically. The study is carried out in partnership with the Hospital de las Culturas de San Cristóbal de Las Casas, Chiapas, the Autonomous University of Nuevo León (UANL), the University of Sciences and Arts of Chiapas (UNICACH), and the Colegio de la Frontera Sur (ECOSUR), San Cristóbal Unit.

Literature.

Kilgore PE, Salim AM, Zervos MJ, Schmitt H-J. Pertussis: Microbiology, Disease, Treatment, and Prevention. Clin Microbiol Rev. 2016 Jul;29(3):449–86.

Domenech de Cellès M, Magpantay FMG, King AA, Rohani P. The pertussis enigma: reconciling epidemiology, immunology and evolution. Proc Biol Sci. 2016 Jan 13;283(1822).

WHO. Pertussis vaccines: WHO position paper – August 2015. Wkly Epidemiol Rec [Internet]. 2015;90(35):433–460. Available from: http://www.who.int/wer/2015/wer9035.pdf?ua=1

Franco-Esquivel T, De La Paz C, Siqueiros-Ramírez A. Outbreak of Bordetella pertussis and Bordetella holmesii in Mexicali, Baja California, México. J Vaccines Vaccin [Internet]. 2018 [cited 2018 May 15];9. Available from: https://www.omicsonline.org/proceedings/outbreak-of-bordetella-pertussis-and-bordetella-holmesii-in-mexicali-baja-california-mxico-83893.html

Revista Sin embargo. Médicos alertan por brote de tosferina entre jornaleros indígenas en Guanajuato y sus hijos; una bebé muere. Junio. 2017 [cited 2018 May 14];1. Available from: http://www.sinembargo.mx/17-06-2017/3243060

Proceso. Catorce muertos por epidemia de tosferina en comunidades de Chiapas. Proceso [Internet]. 2007 [cited 2018 May 14];1. Available from: https://www.proceso.com.mx/208904/catorce-muertos-por-epidemia-de-tosferina-en-comunidades-de-chiapas

Plano Informativo. Posible brote de tosferina en Chiapas. Plano Informativo [Internet]. 2013 [cited 2018 May 14];1. Available from: http://planoinformativo.com/231646/posible-brote-de-tos-ferina-en-chiapas-nacionales

Animal Político. Instalan cerco sanitario en comunidad de Chiapas por bacteria mortal. Animal Político [Internet]. 2013;1. Available from: https://www.animalpolitico.com/2013/01/instalan-cerco-sanitario-en-comunidad-de-chiapas-ante-bacteria-mortal/

Sánchez-Pérez HJ, Arana-Cedeño M, Ely-Yamin A, Ford D. Excluded people, eroded communities. Realizing the right to health in Chiapas, Mexico. United States of America; 2006 p. 73.

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