Document Type : Original Research


1 Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran

2 Iranian Society for Support of Patients with Infectious Diseases, Tehran, Iran


Background and Aims: Pertussis is a highly contagious, vaccine-preventable disease. Determination of the seroepidemiology of pertussis makes possible the evaluation of pertussis immunity in a population. In this study, we determined the seroprevalence of Bordetella pertussis IgG antibodies in different age groups in Tehran, Iran.
Materials and Methods: Overall, 1101 subjects between ages of 8 months and 20 years were tested for the presence of pertussis toxin (PT), filamentous hemagglutinin (FHA) and different lipopolysaccharides (LPS) antibodies by ELISA.
Results: The overall prevalence of pertussis antibodies was 48% and the mean antibody level was 44± 47.7 U/ml. Over half (53.1%) of the children aged 8 months to 6 years were negative for pertussis antibodies. Pertussis antibodies rates and levels were significantly different between age groups (P < 0.001) and their significant elevations were observed with increasing age.
Conclusion: Up to half of the vaccinated children lacked an antibody response to vaccine, so using a more immunogenically effective vaccine to ensure sufficient immunity is essential. We showed that B. pertussis infection is on the rise in Iranian adolescents and young adults. Booster vaccination of this age group appears to be the most logical approach to disease prevention in adolescents and control the circulation of the organism.


  1. Senzilet LD, Halperin SA, Spika JS, Alagaratnam M, Morris A, Smith B. Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clin Infect Dis. 2001; 32:1691–7.
  2. Wright SW.  Pertussis infection in adults. South Med J 1998; 91:702-8.
  3. Cherry JD. The epidemiology of pertussis and pertussis immunization in the United Kingdom and the United States: a comparative study. Curr Probl Pediatr 1984; 14:1-78.
  4. Cherry JD, Brunnell PA, Golden GS, Karen DT. Report of the Task Force on pertussis and pertussis immunization. Pediatrics 1988; 81(Suppl.):939-84.
  5. Socan M, Prosenc K, Vegnuti M. Seroprevalence of IgG antibodies to pertussis toxin in the Slovene population. Wien Klin Wochenschr. 2006; 118(11-12):336-40.
  6. Healy CM, Munoz FM, Rench MA, Halasa NB, Edwards KM, Baker CJ. Prevalence of pertussis antibodies in maternal delivery, cord, and infant serum. J Infect Dis 2004; 190:335–340.
  7. Zarei S, Jeddi-Tehrani M, Akhondi MM, Zeraati H, Pourheidari F, Ostadkarampour M, et al. Primary immunization with a triple diphtheria-tetanus-whole cell pertussis vaccine in Iranian infants: an analysis of antibody response. Iran J Allergy Asthma Immunol. 2009; 8(2):85-93.
  8. Movahedi M, Haghdoost AA, Pournik O, Hajarizadeh B, Fallah MS. Temporal variations of health indicators in Iran comparing with other Eastern Mediterranean Region countries in the last two decades. J Public Health. 2008; 30(4):499-504
  9. Zahraei SM, Doosti F. Distribution of pertussis in Iran in 2007. The 17th Iranian congress on Infectious diseases and tropical medicine. Tehran, Iran. 2008. p. 129.
  10. Ward JI, Cherry JD, Chang SJ, Partridge S, Lee H, Treanor J, et al. Efficacy of an acellular pertussis vaccine among adolescents and adults. N Engl J Med 2005; 353:1555-63.
  11. Broder KR, Cortese MM, Iskander JK, Kretsinger K, Slade BA, Brown KH, et al. Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006; 55(RR-3):1-34.
  12. Chan SH, Tan PT, Han HH, Bock HL. Immunogenicity and reactogenicity of a reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine as a single-dose booster in Singaporean adults. Singapore Med J 2006; 47:286-90.
  13.  Wharton M. Prevention of pertussis among adolescents by vaccination: taking action on what we know and acknowledging what we do not know. Clin Infect Dis 2004; 39:29-30.
  14. Campins-Marti M, Cheng HK, Forsyth K, Guiso N, Halperin S, Huang LM, et al. Recommendations are needed for adolescent and adult pertussis immunisation: rationale and strategies for consideration. Vaccine 2001; 20:641-6.
  15. von Konig CH, Halperin S, Riffelmann M, Guiso N. Pertussis of adults and infants. Lancet Infect Dis 2002; 2:744-50.
  16. Diez-Domingo J, Ballester A, Baldo JMPlanelles MV, Villarroya JV, Alvarez T, et al. Incidence of pertussis in persons < or =15 years of age in Valencia, Spain: seroprevalence of antibodies to pertussis toxin (PT) in children, adolescents, and adults. J Infect. 2004;49(3):242-7.
  17. Garcia-Corbeira P, Dal-Re R, Aguilar L, Garcia-de-Lomas J. Seroepidemiology of Bordetella pertussis infections in the Spanish population: a cross-sectional study.Vaccine. 2000;18(21):2173-6.
  18. Wilder-Smith A, Ng S, Earnest A. Seroepidemiology of pertussis in the adult population of Singapore. Ann Acad Med Singapore. 2006;35(11):780-2.
  19. Strebel P, Nordin J, Edwards K, Hunt J, Besser J, Burns S, et al. Population-based incidence of pertussis among adolescents and adults, Minnesota, 1995–1996. J Infect Dis. 2001; 183:1353–9.
  20. Mink CM, Cherry JD, Christenson P, Lewis K, Pineda E, Shlian D, et al. A search for Bordetella pertussis infection in university students. Clin Infect Dis. 1992; 14:464–471.
  21. Keitel WA, Edwards KM. Pertussis in adolescents and adults: time to reimmunize? Semin Respir Infect 1995; 10:51-7.
  22. Purdy KW, Hay JW, Botteman MF, Ward JI. Evaluation of strategies for use of acellular pertussis vaccine in adolescents and adults: a cost-benefit analysis. Clin Infect Dis 2004; 39:20-8.
  23. Greco D, Salmaso S, Mastrantonio P, Giuliano M, Tozzi AE, Anemona A, et al. A controlled trial of two acellular vaccines and one whole-cell vaccine against pertussis. N Engl J Med 1996; 334:341–348.
  24. Polyzou A, Pournaras S, Dafni U, Sofianou D, Christeli E, Patrinos S, et al. Sero epidemiology of Bordetella pertussis immune responses in a healthy population in northern Greece.J Clin Lab Anal. 2004; 18(3):211-4.
  25. Zarei S, Jeddi-Tehrani M, Akhondi MM, Zeraati H, Kheirkhah T, Ghazanfari M, et al. Immunogenicity of a triple diphtheria-tetanus-whole cell pertussis vaccine in Iranian preschool children. Iran J Immunol. 2007; 4(2):101-9.
  26. Sherkat R, Salehy H, Yazdani R. The assessment of the bordetella pertussis in adults with cough ≥ 6 weeks. The 14th Iranian Congress on Infectious Diseases and Tropical Medicine. 2005. p. 216.
  27. Hashemi SH, Ranjbar M, Hajilooi M, Seif-Rabiei MA, Bolandi M, Moghimi J. Seroprevalence of Immunoglobulin G antibodies against pertussis toxin among asymptomatic medical students in the west of Iran: a cross sectional study. BMC Infect Dis. 2009; 9:58.