Pertussis Resurgence Associated with Pertactin-Deficient and Genetically Divergent Bordetella Pertussis Isolates in Israel.

The Bordetella pertussis polymerase chain reaction positivity rate changed after additional diphtheria-tetanus-acellular pertussis boosters in 2005 and 2008, 9.8%, 13.4%, 22% and 15.2% in 2010, 2011, 2012 and 2013, P < 0.001, respectively. New pulsed-field gel electrophoresis profiles were detected between 2009 and 2012. The proportion of pertactin-deficient isolates increased over time, 6.6% versus 7.1% versus 33.3% during 2005-2006, 2011-2012 and 2013-2014, P < 0.03, respectively.