Diagnosis of recent infection with Bordetella pertussis in patients with symptoms consistent with whooping cough for 2 or more weeks
This test should not be used in neonates, young infants or in children between the ages of 4 to 7 years as the routine childhood vaccine schedule may interfere with result interpretation.
This test should not be used as a test of cure, to monitor response to treatment, or to determine vaccine status.
This test may be used to diagnose recent infection with Bordetella pertussis in patients who have not had the acellular pertussis vaccine or booster in the last 6 months.
Enzyme-Linked Immunosorbent Assay (ELISA)
Whooping cough
B. pertussis infection
Serum
This test should be ordered in patients with 2 or more weeks of symptoms consistent with whooping cough. Nucleic acid amplification testing for Bordetella pertussis should be used in patients who have been symptomatic less than 2 weeks; order BPRP / Bordetella pertussis and Bordetella parapertussis, Molecular Detection, PCR, Varies.
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Heat inactivated | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 30 days | |
Frozen | 30 days |
Diagnosis of recent infection with Bordetella pertussis in patients with symptoms consistent with whooping cough for 2 or more weeks
This test should not be used in neonates, young infants or in children between the ages of 4 to 7 years as the routine childhood vaccine schedule may interfere with result interpretation.
This test should not be used as a test of cure, to monitor response to treatment, or to determine vaccine status.
Bordetella pertussis, the causative agent of whooping cough, is highly contagious and remains endemic in the United States despite the high rate of vaccination. Acute B pertussis infections are typically diagnosed by culture or nucleic acid amplification testing (NAAT). However, symptomatic adults and adolescents often seek medical attention later in the course of infection, at which time the sensitivity of these 2 methods to detect the infectious agent decreases. A serologic response to B pertussis is typically mounted 2 weeks following infection, and therefore, detection of IgG-class antibodies to pertussis toxin (PT), which is only produced by B pertussis, can be a useful adjunct for diagnosis at later stages of illness.
Prior to testing, providers should review whether the patient was recently vaccinated using the Tdap (Tetanus-Diphtheria-acellular Pertussis) or DTap vaccines. The acellular pertussis vaccine contains 1 to 5 B pertussis antigens, including filamentous hemagglutinin, pertactin, 2 fimbrial agglutinogens, and significant levels of PT. Therefore, recent vaccination for B pertussis, specifically within the last 2 to 6 months, may lead to a positive result by the anti-PT IgG assay, and knowledge of the patient's vaccination history is important for accurate result interpretation.
> or =100 IU/mL (Positive)
40-<100 IU/mL (Borderline)
<40 IU/mL (Negative)
Reference values apply to all ages.
Negative (<40 IU/mL): No IgG antibodies to pertussis toxin (PT) detected. Results may be falsely negative in patients with less than 2 weeks of symptoms.
Borderline (40-<100 IU/mL): Recommend follow-up testing in 10 to 14 days if clinically indicated.
Positive (> or =100 IU/mL): IgG antibodies to PT detected. Results suggest recent infection with or recent vaccination against Bordetella pertussis.
Immune response following vaccination cannot be distinguished from recent infection.
For diagnosis, clinical symptoms, the patient's age and vaccination history should always be taken into account along with the serological results.
Whooping cough caused by Bordetella parapertussis will not be detected by this assay.
The Centers for Disease Control and Prevention recommend nucleic acid amplification tests (NAAT) or culture as first-line tests for B pertussis infection. However, serologic testing may be useful in patients who are symptomatic for more than 2 weeks.
Accuracy:
A total of 108 previously characterized serum samples (originally tested by Focus Diagnostics Inc.) were evaluated by the EuroImmun antipertussis toxin (PT) IgG EIA and the results are indicated below.
Comparison of the EuroImmun and Focus Diagnostics Bordetella pertussis PT EIAs | |||
| Focus Diagnostics PT EIA | ||
Positive | Negative | ||
EuroImmun PT EIA | Positive | 18 | 0 |
Negative | 0 | 77 | |
Borderline(a) | 8(b) | 5(c) |
(a) Testing of a convalescent sample is recommended. Samples not included in positive and negative agreement calculations below.
(b) All 8 samples had low positive values by the Focus assay.
(c) All 5 samples were near the lower end of the borderline range for the EuroImmun ELISA.
Positive Agreement: 100% (18/18); 95% CI: 79.3%-100%
Negative Agreement: 100% (77/77); 95% CI: 94.3%-100%
1. Leber AL. Pertussis: relevant species and diagnostic update. Clin Lab Med. 2014;34(2):237-255
2. Guiso N, Berbers G, Fry NK, et al. What to do and what not to do in serological diagnosis of pertussis: recommendation from EU reference laboratories. Eur J Clin Microbiol Infect Dis. 2011;30(3):307-312
3. Andre P, Caro V, Njamkepo E, Wendelboe AM, Van Rie A, Guiso N. Comparison of serological and real-time PCR assays to diagnose Bordetella pertussis infection in 2007. J Clin Microbiol. 2008;46(5):1672-1677
The antipertussis toxin (PT) IgG enzyme-linked immunosorbent assay (ELISA) test is a quantitative assay. Microtiter wells are coated with PT from Bordetella pertussis and diluted patient samples, calibrators, and controls are incubated in the wells. If present, antibodies to Bordetella pertussis will bind to the antigen. After wells are washed, enzyme-labeled antihuman IgG is added, and wells are incubated a second time. After incubation, wells are washed and a tetramethylbenzidine chromogen/substrate solution is added and wells are incubated. Stop solution is added to stop the reaction. Wells are read using a microplate reader with 450/620 nm wavelength. Calibrator values are plotted to make a point-to-point standard curve. Sample antibody concentrations are determined using the standard curve.(Package insert: Anti-Bordetella pertussis toxin ELISA (IgG) Test Instructions. EUROIMMUN US; 03/05/2019)
Thursday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
86615
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
BORDG | B. pertussis Ab, IgG, S | 42330-1 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
BIGG | B. pertussis IgG | 29659-0 |
DEXBG | B.pertussis Value | 42330-1 |