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The Journal of Medical Microbiology, Vol 27, Issue 4 247-254, Copyright © 1988 by Society for General Microbiology

JOURNAL ARTICLE

Whooping cough diagnosis: a clinical evaluation of complementing culture and immunofluorescence with enzyme-linked immunosorbent assay of pertussis immunoglobulin A in nasopharyngeal secretions

P. B. Campbell, P. L. Masters and E. Rohwedder
Department of Microbiology, Princess Margaret Hospital for Children, Subiaco, Western Australia.

Pernasal aspirate (PNA) was obtained from 543 children during a 6-month period when whooping cough was prevalent. Three tests for diagnosing pertussis were performed on the PNA: (a) examination of direct smears by immunofluorescence (IF) for Bordetella pertussis; (b) culture; and (c) estimation of B. pertussis-specific immunoglobulin-A antibody (P-IgA) by an enzyme-linked immunosorbent assay (ELISA). On clinical review, 395 children were assessed to have had pertussis (P children) and 148 children not to have had pertussis (non-P children). The non-P children comprised 66 admitted to hospital for acute respiratory infections and 82 outpatients suspected of having pertussis. Analysis of the results of the tests on the PNAs of the non-P children helped to assess the P-IgA test. The analysis showed that artificial immunisation against pertussis did not affect the antibody results, but that non-specific positive results occur requiring the labelling of many P-IgA results as "doubtful". Among the 395 P children, 36% yielded positive cultures and more than half of these also had positive IF tests. The ELISA for P-IgA was positive in 24% of all the P children, equivalent to nearly 40% of the culture-negative P children. For the 148 non-P children, IF and culture-negative by definition, the P-IgA test was positive in 9%. The antibody test result was doubtful in 28% of the P children and in 40% of the non-P children. Estimation of P-IgA antibodies in PNA is a useful and economic complement to culture and IF in the diagnosis of pertussis.(ABSTRACT TRUNCATED AT 250 WORDS)


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A.K. H. BERSTAD, J. HOLST, L.O. FROHOLM, I.L. HAUGEN, E. WEDEGE, F. OFTUNG, and B. HANEBERG
A nasal whole-cell pertussis vaccine induces specific systemic and cross-reactive mucosal antibody responses in human volunteers
J. Med. Microbiol., February 1, 2000; 49(2): 157 - 163.
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