Pertussis diagnostics: overview and impact of immunization

Area of Science:

• Microbiology
• Infectious Diseases
• Immunology

Background:

• Pertussis, caused by Bordetella pertussis and Bordetella parapertussis, remains a concern in vaccinated populations.
• Immunity wanes over time, leading to infections in adolescents and adults.
• Unvaccinated infants and children are also at risk.

Purpose of the Study:

• To emphasize the importance of considering pertussis in patients with prolonged coughs, regardless of vaccination status.
• To highlight the necessity of laboratory confirmation for suspected pertussis cases.
• To review diagnostic methods for pertussis.

Main Methods:

• Review of clinical presentation and diagnostic approaches for pertussis.
• Discussion of laboratory methods including culture, PCR, and serology.
• Consideration of hyperleukocytosis in infant diagnosis.

Main Results:

• Clinical symptoms of pertussis are often non-specific.
• Nonspecific laboratory tests generally lack diagnostic value.
• Specific tests like culture and PCR detect bacteria or DNA directly.
• Serology is useful for late-stage diagnosis but cannot differentiate infection from vaccination.

Conclusions:

• Pertussis should be suspected in prolonged cough cases, irrespective of vaccination history.
• Laboratory confirmation is essential for accurate pertussis diagnosis.
• Specific diagnostic methods are required, with serology having limitations in distinguishing past infection from vaccination.