Pernasal swab for whooping cough (Pertussis)

Microbiology

Notes

Bordetella pertussis colonies growing on Charcoal Agar 

  • This is the recommended sample for acute Bordetella pertussis infection (whooping cough).
  • A pernasal swab with a thin, flexible wire shaft must be used. These can be ordered from Pathology supplies.
  • Swabs with a rigid shaft are unsuitable and will not be processed.
  • Sampling of nasopharyngeal secretions in patients with whooping cough may precipitate a paroxysm of coughing and cause obstruction of the airways. Resuscitation equipment must be available if whooping cough is suspected. The specimen collector should avoid exposure to direct coughs from the patient.
  • PCR testing of a pernasal swab or nasopharyngeal aspirate is recommended for any acutely ill child age ≤ 12 months admitted to an intensive care unit or a paediatric ward with respiratory illness compatible with pertussis.
  • For persistant symptoms of more than 2 weeks a Bordetella pertussis antibody test may be of value.
  • Pertussis (whooping cough) is a notifiable disease. Click for notification form.

Sample requirements

Pernasal charcoal transport swab

Pernasal swab for bacteriology

Collection method

Pernasal sampling technique

  • Seat the patient, looking upwards with the neck fully extended
  • Insert the pernasal swab through a nostril and advance along the floor of the nose until it reaches the nasopharynx.
  • It has been suggested that the swab be held against the posterior nasopharynx for up to 30 seconds or until the patient coughs. In practice, it is more likely that a patient will only be able to tolerate this for a few seconds.
  • Remove the swab and plunge into transport tube

Required information

  • Relevant clinical details
  • Date of onset
  • Recent, current and intended antibiotics

Storage/transport

Store and transport at room temperature. Samples should be transported to the laboratory with minimal delay.

Turnaround time

Culture up to 7 days

PCR 1 to 2 days


Page last reviewed: 20/01/2014