Which laboratory tests are recommended for confirming a diagnosis of pertussis in primary care settings?

Recommended laboratory tests for confirming pertussis diagnosis in primary care:

• Polymerase chain reaction (PCR) testing of nasopharyngeal swabs is the preferred diagnostic test for pertussis in primary care settings due to its high sensitivity and rapid results.
• Culture of Bordetella pertussis from nasopharyngeal specimens can be performed but is less sensitive and slower than PCR, and is generally reserved for public health surveillance or confirmation.
• Serological testing is not routinely recommended in primary care for acute diagnosis because antibodies take time to develop and are more useful in later stages or epidemiological studies.

These recommendations align with Public Health England and UK Health Security Agency guidance emphasizing nucleic acid amplification tests (such as PCR) as the mainstay for pertussis confirmation in clinical practice.

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