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Kinetics and sensitivity of ELISA IgG pertussis antitoxin after infection and vaccination with Bordetella pertussis in young children

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Hallander HO, Ljungman M, Storsaeter J, Gustafsson L. Kinetics and sensitivity of ELISA IgG pertussis antitoxin after infection and vaccination with Bordetella pertussis in young children. APMIS 2009.

Sera from 96 young children in a vaccine trial were analysed for kinetics of ELISA IgG anti-pertussis toxin (anti-PT) after a laboratory-verified pertussis infection. The antibody decay curves after infection were biphasic and similar in shape to those after vaccination. The change from a rapid to a slower decay after the peak occurred about 4–5 months from the first day of cough. In a group of children given a two- or a five-component acellular pertussis vaccine the proportion of sera above the tentative cut-off values for anti-PT of 20, 50 or 100 EU/ml 12 months after onset of the infection were 19%, 0% and 0% respectively. Corresponding figures for a whole-cell or placebo vaccine group of infected children were significantly higher, 73%, 39% and 30%, i.e. the antibody decay after infection in young children depends on vaccination status as well as on the pertussis vaccine given. In a large group of non-infected children vaccinated with the same five-component acellular vaccine 13%, 0% and 0% had sera above 20, 50 and 100 EU/ml at 12 months after the third vaccine dose and all were below the minimum level of detection 2 years after vaccination. In conclusion, knowledge about anti-PT kinetics is essential for the interpretation of seroepidemiological data but hardly offers the possibility to establish valid cut-off values for anti-PT in single sample serology. An option would be to identify a grey zone between the positive and negative ends of the distribution for follow-up testing by a second serum.
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Keywords: ELISA IgG anti-PT; Pertussis; Sweden; post-infection kinetics; serology; single serum diagnosis

Document Type: Research Article

Affiliations: 1: Swedish Institute for Infectious Disease Control, Solna, Sweden 2: Norwegian Institute of Public Health, Oslo, Norway

Publication date: 2009-11-01

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