The introduction of PCR in 2007 (in the Sofia area) and the evolution of the serology tests from 2006 to 2009 ( Table 2 ), moving from passive hemagglutination test, immunofluorescence and culture to PCR and more quantitative serological ELISA tests, also appear to coincide with a decreasing trend in the incidence of reported pertussis.
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Comparative Epidemiologic Characteristics of Pertussis in 10 Central and Eastern European Countries, 2000-2013.
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