Whooping cough, also known as pertussis, is sometimes regarded primarily as a childhood disease controlled through vaccination.
The reality is more complicated.
Pertussis continues to circulate globally and remains particularly dangerous for young infants. The World Health Organization (WHO) reported more than 264,000 pertussis cases worldwide in 2025, while noting that infants face the greatest risk of severe disease.
For clinicians and laboratories, pertussis also presents an important diagnostic challenge.
Early symptoms can resemble those of other respiratory infections, while Bordetella pertussis is not the only Bordetella species capable of causing a whooping cough-like illness.
This creates an important question for laboratories:
Can we rapidly determine whether a symptomatic patient’s respiratory illness is associated with Bordetella; and which clinically relevant species is present?
The Bosch Vivalytic Bordetella test uses qualitative real-time PCR to detect Bordetella pertussis, Bordetella parapertussis and Bordetella holmesii from nasopharyngeal swabs, with results available in approximately 47 minutes.
What Is Pertussis or Whooping Cough?
Pertussis is a highly contagious respiratory infection primarily caused by the bacterium Bordetella pertussis.
The infection spreads mainly through respiratory droplets produced when an infected person coughs or sneezes.
The cough can subsequently develop into repeated and sometimes severe coughing episodes. The characteristic “whoop” associated with the disease can occur when the patient breathes in following a coughing episode.
Why Can Pertussis Be Particularly Dangerous for Infants?
Although people of different ages can develop pertussis, the disease is particularly concerning in young infants.
WHO describes pertussis as a significant cause of illness and death in this age group. Pneumonia is a relatively common complication, while neurological complications such as seizures and brain disease can occur less frequently.
Young infants present another difficulty.
They may be too young to have completed their primary vaccination series, leaving them particularly vulnerable during the first months of life.
Evidence from low and middle-income countries reinforces this concern.
Is Pertussis Still a Concern in Africa?
Yes, but determining its true burden is difficult.
Research examining pertussis across Africa has repeatedly highlighted limitations in surveillance and laboratory confirmation.
A systematic review covering school-age children, adolescents and adults found evidence of continued pertussis circulation in different African countries despite vaccination programmes. It also concluded that inadequate surveillance means infection rates and disease burden are poorly documented and potentially underestimated in many settings.
Earlier research focusing on West Africa reached a similar conclusion: without specific surveillance systems and suitable hospital-level diagnostics, obtaining reliable information about pertussis morbidity and mortality is difficult.
This distinction is worth noting.
- Few reported cases do not necessarily mean little circulation.
- Low case numbers can also reflect limited testing, surveillance or reporting.
Recent research provides an interesting example.
A prospective study involving infants in Antananarivo, Madagascar, found Bordetella infection by qPCR in 22% of participating infants who met the study’s inclusion criteria. The researchers also found substantial positivity among household contacts and emphasised the importance of molecular diagnosis for detecting disease.
These results should not be extrapolated to Africa as a whole. They do, however, demonstrate why laboratory-confirmed surveillance can reveal information that clinical diagnosis alone may miss.
Why Can’t Whooping Cough Always Be Diagnosed From Symptoms?
The characteristic cough associated with pertussis may make the disease appear straightforward to recognise.
But clinical presentation alone has limitations.
Early pertussis symptoms can resemble those of other respiratory infections, and not every patient develops the characteristic whoop.
Bosch similarly notes in its Vivalytic Bordetella clinical information that definitive diagnosis cannot be based purely on clinical symptoms and identifies PCR, culture and serology among the laboratory methods available for diagnosis.
This makes laboratory testing important both for individual diagnostic investigations and for understanding disease circulation.
What Role Does PCR Play in Pertussis Testing?
PCR detects specific genetic material associated with the pathogen being investigated.
- For pertussis, real-time PCR can provide relatively rapid detection compared with workflows that depend solely upon bacterial culture.
- Obtaining bacterial isolates can support further investigation, including molecular epidemiology and antimicrobial susceptibility assessment.
The appropriate question for a laboratory is therefore not necessarily:
“Should we use PCR or culture?”
It may instead be:
“How could rapid PCR complement our existing pertussis diagnostic and surveillance workflow?”
Bordetella Pertussis Is Not the Only Species That Matters
Bordetella pertussis is the principal cause of whooping cough.
However, other Bordetella species can produce similar illness.
The Vivalytic Bordetella assay detects three:
| Bordetella Species | Vivalytic Gene Target |
|---|---|
| Bordetella pertussis | IS481 |
| Bordetella parapertussis | pIS1001 |
| Bordetella holmesii | IS481 and hIS1001 |
These targets are specified in the Bosch Vivalytic test portfolio.
The ability to distinguish these organisms matters because identifying Bordetella at the species level can provide more specific information than simply detecting a generic pertussis-like infection.
Bosch estimates that B. parapertussis may account for a proportion of Bordetella infections, while both B. parapertussis and B. holmesii can cause whooping cough-like disease.
How Does the Vivalytic Bordetella PCR Test Work?
The Vivalytic Bordetella test uses qualitative real-time PCR.
According to the Bosch portfolio, the test uses nasopharyngeal swabs and requires a sample volume of 300 μL.
Results are available in approximately 47 minutes.
| Specification | Vivalytic Bordetella |
|---|---|
| Detectable Pathogens | Bordetella pertussis; Bordetella parapertussis; Bordetella holmesii |
| Gene Targets | IS481; pIS1001; IS481/hIS1001 respectively |
| Detection Method | Qualitative real-time PCR |
| Sample Material | Nasopharyngeal swabs |
| Time-to-Result | Approx. 47 minutes |
| Field of Application | Symptomatic patients |
| Intended Setting | Professional and laboratory use |
| Sample Volume | 300 μL per test |
| Transport Medium (1 ml) | eNAT® transport medium (Copan) |
Bosch positions the assay around fast laboratory testing for outbreak containment and states that the workflow requires no additional laboratory equipment.
Laboratory professionals can review the manufacturer’s specifications through the official Bosch Vivalytic Bordetella test page.
What Could a Result in Approximately 47 Minutes Mean?
A 47-minute analytical result does not automatically mean a complete patient journey takes 47 minutes.
- Sample collection, transport, laboratory workload, result validation, reporting and clinical interpretation all contribute to real-world turnaround time.
However, rapid molecular detection can potentially provide useful information much earlier in the diagnostic pathway.
This may become particularly relevant during:
- suspected outbreaks,
- hospital investigations,
- paediatric respiratory presentations,
- epidemiological surveillance, or circumstances where rapid differentiation of respiratory pathogens is clinically useful.
Bosch’s Vivalytic Bordetella workflow involves only a few steps from sample to result and is designed to operate without additional laboratory equipment for the assay.
Evidence Behind the Vivalytic Bordetella Assay
Laboratory managers evaluating diagnostic equipment should also look beyond manufacturers’ headline specifications and consider available performance evidence.
Bosch has published results from an evaluation presented at ECCMID 2024 involving clinical nasopharyngeal specimens and additional prepared samples covering B. pertussis, B. parapertussis and B. holmesii.
In the 411 Croatian samples detected, the cartridge reported an overall positive agreement of 97.7% across the three targets.
That figure should be understood within the design and sample population of that particular evaluation, rather than treated as a universal real-world performance guarantee.
More recent research also illustrates why laboratories need to follow the validated specimen and transport requirements.
A multicentre evaluation presented at ESCMID 2026 investigated additional specimen types outside the assay’s intended use.
That is actually useful information for prospective users.
Purchasing molecular diagnostic equipment is not simply about choosing an analyser. Sample collection, transport and adherence to the manufacturer’s validated workflow matter too.
One Respiratory Test Within a Wider Molecular Diagnostic Platform
Another important consideration is that Vivalytic is not a dedicated pertussis analyser.
The same platform supports multiple molecular diagnostic applications and assays covering:
- Respiratory infections: including Bordetella, SARS-CoV-2, Influenza A/B and RSV;
- Gastrointestinal infections: including C. difficile, Norovirus and Rotavirus;
- Sexually transmitted infections;
- Nosocomial infections: including MRSA/SA and Candida auris; and
This changes the procurement question considerably.
A laboratory may initially investigate Vivalytic because it needs pertussis testing.
But the stronger business case may depend upon whether one molecular platform can address several diagnostic requirements across the organisation.
That is why expected utilisation across the complete test portfolio should form part of any equipment assessment.
Questions Laboratory Managers Should Consider
Before introducing rapid Bordetella PCR testing, laboratory and healthcare decision-makers should consider:
- How frequently do we currently investigate suspected pertussis?
- Which patient populations are most commonly tested?
- Are specimens processed locally or sent to another laboratory?
- What is our current sample-to-result turnaround time?
- Can our existing testing differentiate B. pertussis, B. parapertussis and B. holmesii?
- Which specimen collection and transport systems do we currently use?
- Would faster confirmation change clinical or infection-control decisions?
- Do we participate in pertussis surveillance?
- What molecular diagnostic infrastructure do we already have?
- What staff training would be required?
- How reliably can cartridges and compatible collection materials be supplied?
- What technical and after-sales support is available?
- Which other Vivalytic assays could our organisation use?
These questions help determine whether the platform addresses a genuine laboratory requirement rather than simply adding another piece of equipment.
Is Your Laboratory Considering Rapid Pertussis PCR Testing?
If your hospital, laboratory, clinic or healthcare organisation is reviewing its pertussis testing, respiratory diagnostics or wider molecular diagnostic capabilities, MediDiagAfrica can provide further information about the Bosch Vivalytic platform and Vivalytic Bordetella assay.
The discussion can begin with your existing requirements:
- How are suspected pertussis cases currently tested?
- How long does it take to receive a result?
- Can your current method distinguish different clinically relevant Bordetella species?
- Could the same molecular platform support additional testing requirements within your organisation?
From there, you can:
Request a Vivalytic demonstration
Discuss your laboratory’s molecular diagnostic requirements
Enquire about Vivalytic availability in your country
Bosch notes that individual Vivalytic products may not be available in every region, so local product availability should be confirmed before procurement.
This article is intended for healthcare and laboratory professionals and provides general diagnostic and product information. It should not replace clinical guidelines, professional medical judgement, local laboratory protocols or applicable regulatory requirements.