Antibodies and the Aberdeen typhoid outbreak of 1964: II. Coombs', complement fixation and fimbrial agglutination tests

Abstract

SUMMARYIn a previous paper (Brodie, 1977) (1) the sensitivity of the anti-human globulin (Coombs') test appeared greater than that of the agglutination test but the length of time (48 h) before results were available rendered it of little value in rapid diagnosis;(2) the complement fixation test offered no particular help towards diagnosis; (3) immunized and non-immunized typhoid fever patients developed fimbrial antibodies, as also did immunized healthy individuals. In this latter group, however, those immunized with alcoholized TAB vaccine had higher antibody titres to fimbrial antigen than those immunized with heat-killed phenolized vaccine.

Salmonella

“…Type-1 fimbrial antibodies, which may be produced by a majority of typhoid patients and vaccinees (Brodie 1977), are responsible for many of the false positive reactions obtained in Widal tests (Duguid 1985).…”

Waterborne infectious disease in Britain

“…Brodie also found a high incidence of Vi antibodies in healthy individuals whether or not inoculated with TAB vaccine, and he therefore concluded that the Vi agglutination test is of little value in screening for typhoid carriage; he also considered that it was of limited value in diagnosis. The continued use of a screening test which will fail to detect one out of three, or at the most four, typhoid carriers, and by which up to 90 % of 'positive' reactions may be given by non-carriers -as for example in South Africa -thus requires considerable justification (Bokkenheuser et al 1964 (Schubert et al 1959), complement fixation, Coomb's anti-human globulin (Brodie, 1977b) and other tests have been tried, but with limited success. Indeed from their work Chau & Chan (1976) concluded that a fluorescent Vi antibody test was superior to other methods for detecting typhoid carriers.…”