1887

Abstract

Summary

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 ; (b) culture; and (c) estimation of -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. The occurrence of non-specific positive results makes evaluation of the clinical features of the child essential to the interpretation of the test.

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1988-12-01
2022-11-28
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References

  1. Baraff L. J., Wilkins J., Wehrle P. F. 1978; The role of antibiotics, immunizations and adenoviruses in pertussis. Pediatrics 61:224–30
    [Google Scholar]
  2. Broome C. V., Fraser D. W., English W. J. 1979; Pertussis diagnostic methods and surveillance. In Manclark C. R., Hill J. C. (eds) International symposium on pertussis U S Departments of Health, Education and Welfare; Bethesda, MD: pp 19–22
    [Google Scholar]
  3. Broomhall J., Herxheimer A. 1984; Treatment of whooping cough: the facts. Archives of Disease in Childhood 59:185–187
    [Google Scholar]
  4. Burstyn D. G., Baraff L. J., Peppier M. S., Leake R. D., St Geme J., Manclark C. R. 1983; Serological response to filamentous hemagglutinin and lymphocytosis-promoting toxin of Bordetella pertussis. Infection and Immunity 41:1150–1156
    [Google Scholar]
  5. Gilligan P. H., Fisher M. C. 1984; Importance of culture in laboratory diagnosis of Bordetella pertussis infections. Journal of Clinical Microbiology 20:891–893
    [Google Scholar]
  6. Goodman Y. E., Wort A. J., Jackson F. L. 1981; Enzyme-linked immunosorbent assay for detection of pertussis immunoglobulin A in nasopharyngeal secretions as an indicator of recent infection. Journal of Clinical Microbiology 13:286–292
    [Google Scholar]
  7. Granstrom M., Granstrom G., Lindfors A., Askelӧf P. 1982; Serologic diagnosis of whooping cough by an enzyme-linked immunosorbent assay using fimbrial hemagglutinin as antigen. Journal of Infectious Diseases 146:741–745
    [Google Scholar]
  8. Johnston Ida, Hill M., Anderson H. R., Lambert H. P. 1985; Impact of whooping cough on patients and their families. British Medical Journal 290:1636–1638
    [Google Scholar]
  9. Lautrop H., Lacey B. W. 1960; Laboratory diagnosis of whooping cough or Bordetella infections. Bulletin of the World Health Organization 23:15–35
    [Google Scholar]
  10. Linnemann C. C. 1979; Host-parasite interactions in pertussis. In Manclark C. R., Hill J. C. (eds) International symposium on pertussis U S Department of Health, Education and Welfare; Bethesda, MD: pp 3–18
    [Google Scholar]
  11. Mertsola J., Ruuskanen O., Kuronen T., Viljanen M. K. 1983; Serologic diagnosis of pertussis: comparison of enzyme-linked immunosorbent assay and bacterial agglutination. Journal of Infectious Diseases 147:252–257
    [Google Scholar]
  12. Nagel J., Poot-Scholtens E. J. 1983; Serum IgA antibody to Bordetella pertussis as an indicator of infection. Journal of Medical Microbiology 16:417–426
    [Google Scholar]
  13. Onorato I. M., Wassilak S. G. 1987; Laboratory diagnosis of pertussis: the state of the art. Pediatric Infectious Disease Journal 6:145–151
    [Google Scholar]
  14. Robertson P. W., Goldberg H., Jarvie B. H., Smith D. D., Whybin L. R. 1987; Bordetella pertussis infection: a cause of persistent cough in adults. Medical Journal of Australia 146:522–525
    [Google Scholar]
  15. Robinson D. A., Mandal B. K., Ironside A. G., Dunbar E. M. 1981; Whooping cough—a study of severity in hospital cases. Archives of Diseases in Childhood 56:687–691
    [Google Scholar]
  16. Scott R., Gardner P. S. 1974; The local antibody response to RS virus infection in the respiratory tract. Journal of Hygiene 72:111–120
    [Google Scholar]
  17. Sutcliffe E. M., Abbott J. D. 1972; Selective medium for the isolation of Bordetella pertussis and parapertussis. Journal of Clinical Pathology 25:732–733
    [Google Scholar]
  18. Voller A., Bartlett A., Bidwell D. E. 1978; Enzyme immunoassays with special reference to ELISA techniques. Journal of Clinical Pathology 31:507–520
    [Google Scholar]
  19. Voller A., Bidwell D. E., Bartlett A. 1980; Enzyme-linked immunosorbent assay. In Rose N. R., Friedman H. (eds) Manual of clinical immunology 2nd ed American Society of Microbiology; Washington, DC: p 366
    [Google Scholar]
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