1887

Abstract

infection is being increasingly recognized as a cause of prolonged, distressing cough (without whooping symptoms) in children and young adults. Diagnosis of infection in this population is important for treatment and surveillance purposes, and may also prove useful in reducing transmission to unvaccinated babies, for whom disease can be fatal. Serum IgG titres against pertussis toxin (PT) are routinely used as a marker of recent or persisting infection. However, collection of serum from young children is difficult, and compliance amongst these subjects to give samples is low. To circumvent these problems, an IgG-capture ELISA capable of detecting anti-PT IgG in oral fluid was devised. The assay was evaluated by comparison to a serum ELISA, using 187 matched serum and oral fluid samples from children (aged 5–16 years) with a history of prolonged coughing, whose serum anti-PT titre had already been determined (69 seropositive, 118 seronegative). The results showed that, using a cutoff of 70 arbitrary units (AU), the oral fluid assay detected seropositive subjects with a sensitivity of 79.7 % [95 % confidence interval (CI) 68.3–88.4] and a specificity of 96.6 % (95 % CI 91.5–99.1). Thus, oral fluid titres of ⩾70 AU would possess a positive predictive value of 76.2–93.2 % for pertussis amongst children with chronic coughs when used as a surrogate for the serum ELISA (assuming disease prevalence of 12–37 %). This oral fluid ELISA will greatly assist in the convenience of disease diagnosis and surveillance.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46543-0
2006-09-01
2019-10-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/55/9/1223.html?itemId=/content/journal/jmm/10.1099/jmm.0.46543-0&mimeType=html&fmt=ahah

References

  1. Berstad, A. K. H., Holst, J., Frohølm, L. O., Haugen, I. L., Wedege, E., Oftung, F. & Haneberg, B. ( 2000; ). A nasal whole-cell pertussis vaccine induces specific systemic and cross-reactive mucosal antibody responses in human volunteers. J Med Microbiol 49, 157–163.
    [Google Scholar]
  2. Birkebaek, N. H., Kristiansen, M., Seefeldt, T., Degn, J., Moller, A., Heron, I., Andersen, P. L., Møller, J. K. & Østergard, L. ( 1999; ). Bordetella pertussis and chronic cough in adults. Clin Infect Dis 29, 1239–1242.[CrossRef]
    [Google Scholar]
  3. Cherry, J. D. ( 1996; ). Historical review of pertussis and the classical vaccine. J Infect Dis 174 (Suppl. 3), S259–S263.[CrossRef]
    [Google Scholar]
  4. Cherry, J. D. ( 1999; ). Epidemiological, clinical, and laboratory aspects of pertussis in adults. Clin Infect Dis 28(Suppl. 2), S112–S117.[CrossRef]
    [Google Scholar]
  5. Crowcroft, N. S., Booy, R., Harrison, T. & 8 other authors ( 2003; ). Severe and unrecognised: pertussis in UK infants. Arch Dis Child 88, 802–806.[CrossRef]
    [Google Scholar]
  6. de Melker, H. E., Versteegh, F. G. A., Conyn-Van Spaendonck, M. A. E., Elvers, L. H., Berbers, G. A., van Der Zee, A. & Schellekens, J. F. P. ( 2000; ). Specificity and sensitivity of high levels of immunoglobulin G antibodies against pertussis toxin in a single serum sample for diagnosis of infection with Bordetella pertussis. J Clin Microbiol 38, 800–806.
    [Google Scholar]
  7. Giammanco, A., Chiarini, A., Maple, P. A. C. & 10 other authors ( 2003; ). European Sero-Epidemiology Network: standardisation of the assay results for pertussis. Vaccine 22, 112–120.[CrossRef]
    [Google Scholar]
  8. Gilberg, S., Njamkepo, E., Du Châtalet, I. P., Partouche, H., Gueirard, P., Ghasarossian, C., Schlumberger, M. & Guiso, N. ( 2002; ). Evidence of Bordetella pertussis infection in adults presenting with persistent cough in a French area with very high whole-cell vaccine coverage. J Infect Dis 186, 415–418.[CrossRef]
    [Google Scholar]
  9. 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. J Clin Microbiol 13, 286–292.
    [Google Scholar]
  10. Granstrøm, G., Askeløf, P. & Granstrøm, M. ( 1988a; ). Specific immunoglobulin A to Bordetella pertussis antigens in mucosal secretion for rapid diagnosis of whooping cough. J Clin Microbiol 26, 869–874.
    [Google Scholar]
  11. Granstrøm, G., Wretlind, B., Salenstedt, C. R. & Granstrøm, M. ( 1988b; ). Evaluation of serologic assays for diagnosis of whooping cough. J Clin Microbiol 26, 1818–1823.
    [Google Scholar]
  12. Hallander, H. O. ( 1999; ). Microbiological and serological diagnosis of pertussis. Clin Infect Dis 28 (Suppl. 2), S99–S106.[CrossRef]
    [Google Scholar]
  13. Harnden, A., Grant, C., Harrison, T., Perera, R., Brueggemann, A. B., Mayon-White, R. & Mant, D. ( 2006; ). Whooping cough in school age children with persistent cough: a prospective cohort study in primary care. BMJ (in press).
    [Google Scholar]
  14. Heininger, U. ( 2001; ). Pertussis: an old disease that is still with us. Curr Opin Infect Dis 14, 329–335.[CrossRef]
    [Google Scholar]
  15. Hudson, L. & Hay, F. ( 1980; ). Affinity chromatography. In Practical Immunology, 2nd edn, pp. 203–215. Oxford, UK: Blackwell Scientific Publications.
  16. McKie, A., Vyse, A. & Maple, C. ( 2002; ). Novel methods for the detection of microbial antibodies in oral fluid. Lancet Infect Dis 2, 18–24.[CrossRef]
    [Google Scholar]
  17. Miller, E., Fleming, D. M., Ashworth, L. A., Mabbett, D. A., Vurdien, J. E. & Elliott, T. S. ( 2000; ). Serological evidence of pertussis in patients presenting with cough in general practice in Birmingham. Commun Dis Public Health 3, 132–134.
    [Google Scholar]
  18. Mortimer, P. P. & Parry, J. V. ( 1988; ). The use of saliva for viral diagnosis and screening. Epidemiol Infect 101, 197–201.[CrossRef]
    [Google Scholar]
  19. Nardone, A., Pebody, R. G., Maple, P. A. C., Andrews, N., Gay, N. J. & Miller, E. ( 2004; ). Sero-epidemiology of Bordetella pertussis in England and Wales. Vaccine 22, 1314–1319.[CrossRef]
    [Google Scholar]
  20. Nigatu, W., Nokes, D. J., Enquselassie, F., Brown, D. W., Cohen, B. J., Vyse, A. J. & Cutts, F. T. ( 1999; ). Detection of measles specific IgG in oral fluid using an FITC/anti-FITC IgG capture enzyme linked immunosorbent assay (GACELISA). J Virol Methods 83, 135–144.[CrossRef]
    [Google Scholar]
  21. Orenstein, W. A. ( 1999; ). Pertussis in adults: epidemiology, signs, symptoms, and implications for vaccination. Clin Infect Dis 28 (Suppl. 2), S147–S150.[CrossRef]
    [Google Scholar]
  22. Perry, K. R., Brown, D. W., Parry, J. V., Panday, S., Pipkin, C. & Richards, A. ( 1993; ). Detection of measles, mumps, and rubella antibodies in saliva using antibody capture radioimmunoassay. J Med Virol 40, 235–240.[CrossRef]
    [Google Scholar]
  23. Senzilet, L. D., Halperin, S. A., Spika, J. S., Alagaratnam, M., Morris, A., Smith, B. & the Sentinel Health Unit Surveillance System Pertussis Working Group (2001; ). Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clin Infect Dis 32, 1691–1697.
    [Google Scholar]
  24. Sheppard, C., Cohen, B., Andrews, N. & Surridge, H. ( 2001; ). Development and evaluation of an antibody capture ELISA for detection of IgG to Epstein–Barr virus in oral fluid samples. J Virol Methods 93, 157–166.[CrossRef]
    [Google Scholar]
  25. Strebel, P., Nordin, J., Edwards, K., Hunt, J., Besser, J., Burns, S., Amundson, G., Baughman, A. & Wattigney, W. ( 2001; ). Population-based incidence of pertussis among adolescents and adults, Minnesota, 1995–1996. J Infect Dis 183, 1353–1359.[CrossRef]
    [Google Scholar]
  26. Thomas, M. G., Ashworth, L. A., Miller, E. & Lambert, H. P. ( 1989; ). Serum IgG, IgA, and IgM responses to pertussis toxin, filamentous hemagglutinin, and agglutinogens 2 and 3 after infection with Bordetella pertussis and immunization with whole-cell pertussis vaccine. J Infect Dis 160, 838–845.[CrossRef]
    [Google Scholar]
  27. von König, C. H., Halperin, S., Riffelmann, M. & Guiso, N. ( 2002; ). Pertussis of adults and infants. Lancet Infect Dis 2, 744–750.[CrossRef]
    [Google Scholar]
  28. Wilson, M. B. & Nakane, P. K. ( 1978; ). Recent developments in the periodate method of conjugating hoseradish peroxidase (HRPO) to antibodies. In Immunofluorescence and Related Techniques, pp. 215–244. Edited by W. Knapp, K. Holubar & G. Wick. Amsterdam: Elsevier.
  29. Yih, W. K., Lett, S. M., des Vignes, F. N., Garrison, K. M., Sipe, P. L. & Marchant, C. D. ( 2000; ). The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989–1998. J Infect Dis 182, 1409–1416.[CrossRef]
    [Google Scholar]
  30. Zackrisson, G., Lagergård, T., Trollfors, B. & Krantz, I. ( 1990; ). Immunoglobulin A antibodies to pertussis toxin and filamentous hemagglutinin in saliva from patients with pertussis. J Clin Microbiol 28, 1502–1505.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46543-0
Loading
/content/journal/jmm/10.1099/jmm.0.46543-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error