Abstract
The incidence of whooping cough in Romania is substantially underestimated, and, as noted by the health
authorities, this is mostly due to the lack of both awareness and biological diagnosis. We conducted a 1-year
study in Bucharest in order to assess the circulation of Bordetella pertussis, the main etiological agent of
whooping cough. Fifty-one subjects suspected of whooping cough were enrolled. Culture, real-time PCR, and
enzyme-linked immunosorbent assay were used for laboratory diagnosis. Whooping cough patients (63%)
were distributed among all age groups, and most were unvaccinated, incompletely vaccinated, or had been
vaccinated more than 5 years previously. Bordetella holmesii DNA was detected in 22% of the bordetellosis
cases; these patients included adults; teenagers; and, surprisingly, young children. B. pertussis isolates were
similar to the clinical isolates currently circulating elsewhere in Europe. One isolate does not express
pertactin, an antigen included in some acellular pertussis vaccines.