Prospective multinational serosurveillance study of Bordetella pertussis infection among 10- to 18-year-old Asian children and adolescents

Clin Microbiol Infect. 2019 Feb;25(2):250.e1-250.e7. doi: 10.1016/j.cmi.2018.04.013. Epub 2018 Apr 22.


Objectives: Bordetella pertussis continues to cause outbreaks worldwide. To assess the role of children and adolescent in transmission of pertussis in Asia, we performed a multinational serosurveillance study.

Methods: From July 2013 to June 2016, individuals aged 10 to 18 years who had not received any pertussis-containing vaccine within the prior year were recruited in 10 centres in Asia. Serum anti-pertussis toxin (PT) IgG was measured by ELISA. Demographic data and medical histories were obtained. In the absence of pertussis immunization, anti-PT IgG ≥62.5 IU/mL was interpreted as B. pertussis infection within 12 months prior, among them levels ≥125 IU/mL were further identified as infection within 6 months.

Results: A total of 1802 individuals were enrolled. Anti-PT IgG geometric mean concentration was 4.5, and 87 (4.8%) individuals had levels ≥62.5 IU/mL; among them, 73 (83.9%) had received three or more doses of pertussis vaccine before age 6 years. Of 30 participants with persistent cough during the past 6 months, one (3.3%) had level ≥125 IU/mL. There was no significant difference in proportions with anti-PT IgG ≥62.5 IU/mL among age groups (13-15 vs. 10-12 years, 16-18 vs. 10-12 years), between types of diphtheria, pertussis and tetanus (DTP; whole cell vs. acellular), number of doses before age 6 years within the DTP whole-cell pertussis vaccine (five vs. four doses) or acellular pertussis vaccine (five vs. four doses) and history of persistent cough during the past 6 months (yes vs. no).

Conclusions: There is significant circulation of B. pertussis amongst Asian children and adolescents, with one in 20 having serologic evidence of recent infection regardless of vaccination background.

Keywords: Anti-PT IgG; Asian adolescents; Bordetella pertussis; Pertussis infection; Seroepidemiology.

MeSH terms

  • Adolescent
  • Antibodies, Bacterial / blood*
  • Asia / epidemiology
  • Bordetella pertussis / immunology*
  • Child
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Pertussis Toxin / immunology
  • Prospective Studies
  • Risk Factors
  • Seroepidemiologic Studies
  • Whooping Cough / epidemiology*
  • Whooping Cough / transmission


  • Antibodies, Bacterial
  • Immunoglobulin G
  • Pertussis Toxin