What to do and what not to do in serological diagnosis of pertussis: Recommendations from EU reference laboratories

Nicole Guiso, Guy Berbers, Norman Fry, Qiushui He, Marion Riffelmann, C. H. Wirsing Von König, Jussi Mertsola, Sophie Guillot, Hans Hallander, Abdolreza Advani, Frits R. Mooi, Anna Lutynska, Karen Krogfelt, Tine Dalby, Dorothy Xing, Camille Locht, David Hot, Clara Ausiello, Per Sandven, Jann Storsaeter

Research output: Contribution to journalReview articlepeer-review

181 Citations (Scopus)


Bordetella pertussis-specific antibodies can be detected by enzyme-linked immunosorbent assays (ELISAs) or multiplex immunoassays. Assays use purified or mixed antigens, and only pertussis toxin (PT) is specific for B. pertussis. The interpretation of results can be based on dual-sample or single-sample serology using one or two cut-offs. The EU Pertstrain group recommends that: (i) ELISAs and multiplex immunoassays should use purified non-detoxified PT as an antigen, that they should have a broad linear range and that they should express results quantitatively in International Units per millilitre (IU/ml); (ii) a single or dual diagnostic cut-off for single-serum serology using IgG-anti-PT between 50 and 120 IU/ml should be used, and diagnostic serology cannot be validly interpreted for one year after vaccination with acellular pertussis (aP) vaccines; (iii) IgA-anti-PT should only be used with indeterminate IgG-anti-PT levels or when a second sample cannot be obtained. This group discourages using: (i) other antigens in routine diagnostics, as they are not specific; (ii) micro-agglutination, due to its lack of sensitivity; (iii) immunoblots for pertussis serodiagnosis, as results cannot be quantified; (iv) other methods, such as complement fixation or indirect immunofluorescence, due to their low sensitivity and/or specificity.

Original languageEnglish
Pages (from-to)307-312
Number of pages6
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Issue number3
Publication statusPublished - Mar 2011


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