A serologic study of organisms possibly associated with pertussis-like coughing

Pediatr Infect Dis J. 1998 Jul;17(7):645-9. doi: 10.1097/00006454-199807000-00013.


Objective: To assess the frequency of serologic evidence for an infection with microorganisms other than Bordetella pertussis in children with pertussis-like coughs.

Methods: The study was performed within a protective efficacy trial of an acellular pertussis vaccine. Children who coughed for >7 days and had no laboratory evidence of recent infection with B. pertussis were eligible for the present study. Antibodies to Mycoplasma, Chlamydia, respiratory syncytial virus and influenza viruses A and B were measured by complement fixation, and antibodies to adenovirus and parainfluenza viruses 1, 2 and 3 were measured by enzyme-linked immunosorbent assay (ELISA) in acute and convalescent serum samples. Significant titer rises (4-fold titer rise in complement fixation, 100% increase of units in ELISA) and concentrations of antibodies beyond age-specific reference values were regarded as indicative of recent infection. In some children IgM antibodies to Epstein-Barr virus and to cytomegalovirus were also measured by ELISA.

Results: A total of 149 of 1179 (12.6%) children had no laboratory evidence of B. pertussis infection. Serologic evidence for other infections were found in 56% (83 of 149). Adenovirus (33), parainfluenza viruses 1, 2 and 3 (18), Mycoplasma pneumoniae (15) and respiratory syncytial virus (14) were most common. Of this group 48% had been vaccinated against pertussis.

Conclusion: We present data that a proportion of pertussis-like coughs in children may be caused by adenovirus, parainfluenza viruses, respiratory syncytial virus and Mycoplasma. The differential diagnosis of pertussis-like coughs by laboratory methods should include these infections, especially in vaccinated children.

MeSH terms

  • Adenoviridae Infections / diagnosis
  • Adolescent
  • Antibodies, Bacterial / blood*
  • Antibodies, Viral / blood*
  • Child
  • Child, Preschool
  • Cough / blood
  • Cough / microbiology*
  • Cough / virology
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Male
  • Mycoplasma Infections / diagnosis
  • Paramyxoviridae Infections / diagnosis
  • Respiratory Syncytial Virus Infections / diagnosis
  • Serologic Tests
  • Whooping Cough / diagnosis


  • Antibodies, Bacterial
  • Antibodies, Viral