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Syndromic Testing

Spot pertussis early to keep children safe

Following the COVID-19 pandemic, pertussis is making a dangerous comeback, with infants and young children at the highest risk of severe illness. Are you familiar with the best practices for diagnosing and treating it?

We spoke with three pediatric infectious disease specialists about the biggest challenges in pertussis detection and management. Read their opinions, watch the full interviews and then download our report on the value of syndromic testing for pertussis.

Takeaway #1

Gaps in vaccination coverage leave children at risk

Vaccination is the most effective way to prevent severe disease. But vaccine hesitancy and access inequalities have led to gaps in coverage. For example, in Europe, very low prenatal vaccination rates leave newborns unprotected (2).

Early diagnosis, especially in infants, is very important... it has been shown that the earlier we can start the treatment, the better the prognosis.
Lauri Ivaska, MD, PhD, University of Turku

Early differentiation of pertussis is crucial for positive patient outcomes

Pertussis can cause severe illness and even death in newborns. Clinicians can help prevent disease progression by initiating targeted antibiotics early. But differentiating pertussis from other respiratory infections, like RSV and Mycoplasma pneumoniae, can be challenging. Early and accurate diagnosis is critical to prevent complications and improve outcomes.

Culture and serology are important – but not enough

B. pertussis culture is vital for epidemiological surveillance but not for early treatment decisions. This bacterium is challenging to culture in the lab, with results taking up to seven days. Similarly, serology is useful for late-stage diagnosis but is not effective for early detection (4).

Fast and sensitive syndromic testing supports early diagnosis

Differentiating pertussis from other respiratory infections early in the disease course is essential. PCR-based syndromic testing is a fast, sensitive and comprehensive method for early pertussis differentiation, delivering results in about an hour.

But not all tests provide the same reliability.

B. pertussis PCR target sensitivity can vary, affecting test reliability.

The pertussis toxin (PTx) gene is highly specific for B. pertussis but exists in low copy numbers, reducing its sensitivity and reliability.

The IS481 insertion sequence appears in very high copy numbers in B. pertussis, making it highly sensitive. IS481 is also found in some other Bordetella species and can cross-react.

To provide reliable detection of B. pertussis, our QIAstat-Dx respiratory panel uses the IS481 target. Studies show it can detect up to 1/3 more cases than tests that use the PTx target (5,6).

Read the report now
Access expert-backed guidance on syndromic testing for pertussis – one quick download, no sign-up required.

Why early detection and awareness of macrolide resistance matters

Lauri Ivaska, MD, PhD provides a thorough overview of the latest approaches to pertussis detection and management. He covers:

  • Pros and cons of different diagnostic methods, comparing culture with PCR-based syndromic testing
  • Optimal timing and use of diagnostic tools in pertussis
  • Emerging concerns around macrolide resistance in B. pertussis

Addressing challenges in B. pertussis vaccination, diagnosis and management

Nina Dwi Putri, MD discusses the importance of early diagnosis, vaccination and public health strategies in pertussis. She covers:

  • Current trends in vaccination coverage and challenges
  • Differences in prevalence and management of distinct Bordetella species
  • Recommendations for improving surveillance and reporting systems to better track respiratory infections

Addressing the resurgence of Bordetella pertussis infections in children

Danilo Buonsenso, MD, PhD shares his experience managing pertussis cases during the recent epidemic in Italy. He covers:

  • The clinical presentation of pertussis in infants and young children over the disease course
  • The value of syndromic testing for pertussis detection and how expanded access to testing can improve management at the community level
  • The importance of comprehensive pathogen testing and surveillance to better monitor emerging pathogens

Article

  • Poeta M, et al. Pertussis outbreak in neonates and young infants across Italy, January to May 2024: implications for vaccination strategies. Euro Surveill. 2024;29(23):2400301. doi:10.2807/1560-7917.ES.2024.29.23.2400301

Why should you read it?

Covers the pertussis outbreak in Italy, emphasizing the need for heightened awareness ahead of the next pertussis season. Given current trends, similar outbreaks may occur again next spring and summer.

Further articles
  • Ivaska L, et al. Macrolide Resistance in Bordetella pertussis: Current Situation and Future Challenges. Antibiotics (Basel). 2022;11(11):1570. Published 2022 Nov 7. doi:10.3390/antibiotics11111570
  • Rodrigues C, et al. Resurgence of Bordetella pertussis, including one macrolide-resistant isolate, France, 2024. Euro Surveill. 2024;29(31):2400459. doi:10.2807/1560-7917.ES.2024.29.31.2400459

Why should you read it?

Analyzes the global trends in macrolide resistance in B. pertussis, with recent cases reported in France, the UK, and China. Pediatricians should stay informed as resistance patterns continue to evolve.
Provide appropriate care sooner with the aid of QIAstat-Dx syndromic testing

References

  1. European Centre for Disease Prevention and Control. Increase in pertussis cases in the EU/EEA. Published January 26, 2024. Accessed February 11, 2025. https://www.ecdc.europa.eu/en/publications-data/increase-pertussis-cases-eueea
  2. Principi N, et al. Vaccines (Basel). 2024;12(9):1030. doi:10.3390/vaccines12091030
  3. World Health Organization. Immunization coverage. Published July 14, 2023. Accessed February 11, 2025. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
  4. Centers for Disease Control and Prevention. Laboratory Testing for Pertussis. Updated April 2, 2024. Accessed February 24, 2025. https://www.cdc.gov/pertussis/php/laboratories/index.html
  5. van Asten SAV, et al. BMC Microbiol. 2021;21(1):236. doi:10.1186/s12866-021-02289-w
  6. Jerris RC, et al. J Clin Pathol. 2015;68(5):394-396. doi:10.1136/jclinpath-2014-202833

In some cases, data cited pertains to the use of a device from another manufacturer.

For up-to-date licensing information and product-specific disclaimers, see the respective QIAGEN kit instructions for use or user manual. QIAGEN instructions for use and user manuals are available at www.qiagen.com or can be requested from QIAGEN Technical Services (or your local distributor).