Pathogen Safety Data Sheet: Infectious Substances – Bordetella parapertussis

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• Section I: Infectious agent
• Section II: Hazard identification
• Section III: Dissemination
• Section IV: Stability and viability
• Section V: First aid and medical
• Section VI: Laboratory hazards
• Section VII: Exposure controls and personal protection
• Section VIII: Handling and storage
• Section IX: Regulatory and other information
• References

Section I: Infectious agent

Name: Bordetella parapertussis
Agent type: Bacteria

Taxonomy

Family: Alcaligenaceae
Genus: Bordetella
Species: parapertussis

Synonym or cross reference: Pertussis, also known as whooping cough^{Footnote 1Footnote 2}.

Characteristics: B. parapertussis are Gram negative, non-motile coccobacilli measuring approximately 0.5 μm by 0.5-2.0 μm^{Footnote 3}. They are oxidase negative, urease positive, and catalase positive^{Footnote 4}. B. parapertussis are strict aerobes that produce a brownish pigment on tyrosine agar. Optimal growth temperature of B. parapertussis is 35-37 °C^{Footnote 5}. Mature colonies appear in 2-3 days^{Footnote 4}. Virulence factors include filamentous hemagglutinin, adenylate cyclase toxin, pertactin, tracheal cytotoxin, heat-labile toxin and fimbrial adhesins^{Footnote 6}. B. parapertussis lacks some of the virulence factors produced by B. pertussis (e.g., pertussis toxin, tracheal colonization factor)^{Footnote 7}.

Section II: Hazard identification

Pathogenicity/toxicity: Symptoms associated with pertussis caused by B. parapertussis are clinically indistinguishable from those of pertussis caused by B. pertussis; however, they are usually milder and of shorter duration^{Footnote 8,Footnote 9,Footnote 10}. Symptoms can last for a few days (atypical disease) or several months (classic disease), while 40% of affected individuals may be asymptomatic^{Footnote 11}. Less than 5% of illnesses caused by B. parapertussis follow classic disease symptoms, unlike the 75% typical disease symptoms shown with B. pertussis ^{Footnote 12}. Typical disease symptoms occur in three stages. Stage 1 (catarrhal) typically lasts for 1-2 weeks and is characterized by rhinorrhea and mild cough. Stage 2 (paroxysmal) is 4 weeks in duration and is characterized by frequent coughing episodes and an inspiratory whooping sound. Vomiting after coughing episodes commonly occurs^{Footnote 2}. Apnea and cyanosis can also occur^{Footnote 10}. Stage 3 (convalescent) is a chronic cough that can persist for 3 months.

Although infant fatalities caused by B. parapertussis infection have been reported^{Footnote 13}, pertussis caused by B. parapertussis is not considered to be responsible for significant mortality^{Footnote 14}. The disease tends to be most severe in infants and children. Complications include pneumonia and bronchitis^{Footnote 11}.

B. parapertussis can cause chronic non-progressive pneumonia in lambs^{Footnote 15}.  B. parapertussis has also been isolated from the lungs of healthy lambs^{Footnote 15,Footnote 16}. B. parapertussis infection in sheep has been shown to increase their susceptibility to infection by Mannheimia species^{Footnote 3,Footnote 16,Footnote 17,Footnote 18}. Human and ovine B. parapertussis are distinct strains specialized to different hosts^{Footnote 6,Footnote 7,Footnote 16,Footnote 19}. There are no other reported cases of natural animal infection leading to disease.

Communicability: Transmitted via inhalation of droplets that contain the bacteria (e.g., from respiratory secretions), which colonize mucous membranes of the respiratory tract^{Footnote 2}. The attack rate of pertussis in susceptible household members is estimated to be between 70 and 100%^{Footnote 2,Footnote 20}.

Communicability in sheep and lambs is not known.

Epidemiology: B. parapertussis infections occur worldwide. Pertussis epidemics have a cyclic pattern, occurring every 2-5 years^{Footnote 21}. Estimated incidence rates of pertussis caused by B. parapertussis are approximately 2.8 per 1,000 person-years^{Footnote 9}. B. parapertussis comprises 1 to 30 % of pertussis disease^{Footnote 2,Footnote 22,Footnote 23,Footnote 24}. It is most common in children less than 5 years old^{Footnote 12,Footnote 21}.

Host range

Natural Host(s): Humans, sheep^{Footnote 15,Footnote 19}.

Other Host(s): B. parapertussis has the ability to colonize mice and pigs when the bacteria is introduced under experimental conditions^{Footnote 16,Footnote 25}.

Infectious dose: Unknown.

Incubation period: Usually 7 to 10 days^{Footnote 7}, but can range from 6 to 20 days^{Footnote 6}.

Section III: Dissemination

Reservoir: Asymptomatic humans^{Footnote 26}.

Zoonosis/Reverse zoonosis: None.

Vectors: None.

Section IV: Stability and viability

Drug susceptibility: Macrolides such as erythromycin^{Footnote 10}, azithromycin, clarithromycin^{Footnote 2,Footnote 23}; and quinolones such as ciprofloxacin, gemifloxacin, and temafloxacin are effective against B. parapertussis^{Footnote 27,Footnote 28}. Sulfamethoxazole-trimethoprium^{Footnote 10}, piperacillin^{Footnote 29}, and minocycline^{Footnote 29} are also effective against B. parapertussis.

Drug resistance: There are no reports of erythromycin resistant B. parapertussis isolates to date; however, there is evidence of erythromycin resistant B. pertussis emerging in China^{Footnote 30}. B. parapertussis is resistant to benzylpenicillin, cephalothin, cefatrizine, cefaclor, streptomycin, and cephalexin^{Footnote 29}.

Susceptibility to disinfectants: Inactivation of B. pertussis can be achieved using glutaraldehyd^{Footnote 31}.  Vegetative bacteria can be inactivated by chlorine, 70% ethanol, phenolics (e.g., ortho-phenylphenol, ortho-benzyl-para-chlorophenol), hydrogen peroxide, and peracetic acid^{Footnote 32}.

Physical inactivation: Data not available for B. parapertussis. Application of moist heat (121°C for 15 minutes) and dry heat (170°C for 1 hour) are generally effective at eliminating most bacteria^{Footnote 33}.

Survival outside host: Data not available for B. parapertussis. B. pertussis can survive for 3-5 days on dry inanimate surfaces^{Footnote 34}.

Section V: First aid and medical

Surveillance: Diagnosis is accomplished through the monitoring of clinical symptoms. Diagnosis can be performed by culture-based and PCR methods^{Footnote 4,Footnote 24}. Nasopharyngeal swabs are cultured on charcoal agar with 10% horse blood and cephalexin^{Footnote 4}, or Border-Gengou agar^{Footnote 24}.

Note: The specific recommendations for surveillance in the laboratory should come from the medical surveillance program, which is based on a local risk assessment of the pathogens and activities being undertaken, as well as an overarching risk assessment of the biosafety program as a whole. More information on medical surveillance is available in the Canadian Biosafety Handbook (CBH).

First aid/Treatment: B. parapertussis infection can be treated using appropriate antibiotics. Duration of illness is shorter when treatment is administered within 6 days of cough onset^{Footnote 35}. Macrolides such as erythromycin, clarithromycin, and azithromycin are commonly prescribed^{Footnote 2}. Azithromycin has milder side effects and is recommended for infants^{Footnote 2}.

There are no known treatment or immunization options available for animals.

Note: The specific recommendations for first aid/treatment in the laboratory should come from the post-exposure response plan, which is developed as part of the medical surveillance program. More information on the post-exposure response plan can be found in the CBH.

Immunization:  There is no vaccine against B. parapertussis. It is unclear whether acellular pertussis vaccines provide any protection against illness caused by B. parapertussis^{Footnote 9,Footnote 10,Footnote 36,Footnote 37}.

Note: More information on the medical surveillance program can be found in the CBH, and by consulting the Canadian Immunization Guide.

Prophylaxis: Antibiotic prophylaxis may prevent secondary illnesses^{Footnote 35}.

Note: More information on prophylaxis as part of the medical surveillance program can be found in the CBH.

Section VI: Laboratory hazards

Laboratory-acquired infections: None reported to date.

Note: Please consult the Canadian Biosafety Standard (CBS) and CBH for additional details on requirements and guidelines for reporting exposure incidents.

Sources/Specimens: Nasopharyngeal swab or aspirate^{Footnote 2,Footnote 24}.

Primary hazards: Exposure of mucous membranes to aerosols generated during manipulation of B. parapertussis cultures^{Footnote 38}.

Special hazards: None.

Section VII: Exposure controls and personal protection

Risk group classification: B. parapertussis is a Risk Group 2 human pathogen and a Risk Group 2 animal pathogen^{Footnote 39}.

Containment requirements: Containment Level 2 facilities, equipment, and operational practices outlined in the CBS for work involving infectious or potentially infectious materials, animals, or cultures^{Footnote 40}.

Protective clothing: The applicable Containment Level 2 requirements for personal protective equipment and clothing outlined in the CBS should be followed.

Note: A local risk assessment will identify the appropriate hand, foot, head, body, eye/face, and respiratory protection, and the PPE requirements for the containment zone should be documented in Standard Operating Procedures.  

Other precautions: Procedures involving high concentrations of B. parapertussis, or procedures that generate aerosols should be conducted in a biological safety cabinet^{Footnote 40}.

Section VIII: Handling and storage

Spills: Allow aerosols to settle. Wearing protective clothing, gently cover the spill with absorbent paper towel and apply suitable disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up^{Footnote 41}.

Disposal: All materials/substances that have come in contact with the infectious agent must be completely decontaminated before they are removed from the containment zone.  This can be achieved by using a decontamination method that has been demonstrated to be effective against the infectious material, such as chemical disinfectants, autoclaving, irradiation, incineration, an effluent treatment system, or gaseous decontamination^{Footnote 41}.

Storage: The applicable Containment Level 2 requirements for storage outlined in the CBS should be followed. Containers of infectious material or toxins stored outside the containment zone should be labelled, leakproof, impact resistant, and kept either in locked storage equipment or within an area with limited access^{Footnote 41}. 

Section IX: Regulatory and other information

Regulatory information: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment and Climate Change Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.

Canadian Regulatory Context: At the time of publication of this PSDS, this pathogen is subject to official control. The following is a non-exhaustive list of applicable designations, regulation, or legislation:

• Human Pathogen and Toxins Act and Regulations
• National Notifiable Disease (human)
• Health of Animal Act and Regulations
• Transportation of Dangerous Goods Regulations

Updated: August, 2019

Prepared by: Centre for Biosecurity, Public Health Agency of Canada.

Although the information, opinions, and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright^© Public Health Agency of Canada, 2018, Canada

References