Long-term human serum antibody responses after immunization with whole-cell pertussis vaccine in France.

Three hundred sixty children were tested for pertussis serology 0.5 to 1.58 months after complete whole-cell pertussis vaccination. An immunoblot assay was used to detect serum antibodies to pertussis toxin, filamentous hemagglutinin, adenylate cyclase-hemolysin, and pertactin, and agglutination was used for detection of anti-agglutinogen antibodies. Antibodies against pertussis toxin, pertactin, and agglutinogens decreased rapidly after vaccination but increased secondarily, suggesting exposure to infected persons. In contrast, anti-filamentous hemagglutinin antibodies persisted and anti-adenylate cyclase-hemolysin antibodies increased continuously, suggesting either cross-reaction with non-Bordetella antigens or exposure to Bordetella isolates expressing these two antigens, including Bordetella pertussis. These data suggest that unrecognized pertussis is common in France despite massive and sustained immunization in infants and that vaccinated children become susceptible to infection more than 6 years after their last vaccination.

Comparison of polymerase chain reaction, culture, and western immunoblot serology for diagnosis of Bordetella pertussis infection.

Polymerase chain reaction (PCR) amplification of the pertussis toxin promoter region was used to detect Bordetella pertussis infection in nasopharyngeal aspirates collected from 24 infants and children infected with pertussis and 13 adult contacts during an epidemiological study. The sensitivity of this PCR assay was approximately one bacterium, and the assay was specific for B. pertussis in tests with other Bordetella species and other respiratory pathogens. The pertussis case definition required a cough with a duration of more than 21 days for infants and children and laboratory confirmation by serology as the primary detection method for infants, children, and adults. The sensitivity of PCR and culture on Bordet-Gengou agar medium was assessed with regard to the case definitions. In the group of infants and children (index cases), the sensitivities of the culture and the PCR were 54.1% (13 of 24) and 95.8% (23 of 24), respectively. In the adult group (household contacts), the sensitivities of the two methods were 15.4% (2 of 13) and 61.5% (8 of 13), respectively. PCR combined with pertussis-specific serology appears to be a useful tool for diagnosis of pertussis especially in epidemiological studies.

Western blot analysis of antibody responses of young infants to pertussis infection.

Western blot and agglutination techniques were used to analyze the antibody responses to Bordetella pertussis in 27 infants less than six month of age with presumed pertussis infection. The antibody response to the Bordetella pertussis adhesions filamentous hemagglutinin, pertactin and agglutinogens, and to the Bordetella pertussis toxins pertussis toxin and adenylate cyclase-hemolysin were compared. Infection induced intense antibody responses to filamentous hemagglutinin, pertussis toxin and adenylate cyclase-hemolysin. Antibodies to agglutinogens were never detected, and antibodies to pertactin were rarely detected in infected infants' sera. Therefore, determination of anti-agglutinogens levels only is not suitable for the serological diagnosis of pertussis in young infants. Use of purified filamentous hemagglutinin, pertussis toxin and adenylate cyclase-hemolysin in Western blot analysis may improve the serodiagnosis of Bordetella infections. However, care must be exercised in distinguishing between the antibody response in young infants and maternally derived antibodies.