Nucleic acid amplification tests for diagnosis of Bordetella infections

The global epidemiology of pertussis has recently been reviewed (12, 15). Bordetella pertussis continues to circulate even in populations where high vaccination coverage of infants and children is achieved (15, 23), because the protection after natural infection wanes after 10 to 15 years and protection after vaccination lasts for 6 to 10 years (15). A significant increase of pertussis cases was observed in the United States, in Europe, and in other countries with high vaccination coverage, making pertussis a reemerging disease. Transmission of the disease in highly vaccinated populations occurs mainly from adolescents and adults to infants or among older vaccinated children, adolescents, and adults (15). Thus, most cases of pertussis are now observed in unvaccinated infants, older schoolchildren, adolescents, and adults. In outbreak situations asymptomatic carriage has been observed in up to similar to 50% (12).