Pathogenesis
- A membrane-associated protein, P1: functions as a cytoadhesin, binds sialic acid-rich glycolipids found on certain host cell membranes.
- Exotoxin: similar to pertussis toxin, an adenosine diphosphate-ribosylase, death of host cells.
- Organisms are shed in saliva for several days before onset of clinical illness.
- Reinfection is common, symptoms are more severe in older children and young adults.