Antibodies and the Aberdeen typhoid outbreak of 1964: I. The Widal reaction

Abstract

SUMMARYThe outbreak of typhoid fever in Aberdeen during 1964 (Walker, 1965) presented an opportunity to study the antibody titres of typhoid fever patients and of TAB immunized individuals to obtain further knowledge concerning the behaviour of these titres with the passage of time.This paper gives an abbreviated version of part of a research programme which followed the Aberdeen typhoid outbreak of 1964. The antibody titres of patients were followed up for a period of 2 years after discharge from hospital and the findings have been compared with those in TAB immunized healthy individuals. The following points emerged:(1) The value of the Widal test as an aid to diagnosis was limited; (2) the flagellar antibody titre in patients' sera provided a more reliable aid towards diagnosis than did the somatic antibody titre; (3) the response of immunized and non-immunized patients to the somatic antigens was poor and often delayed well into the period following discharge from hospital;(4) titres of 1/40 and over for Vi agglutinins were present in immunized and non-immunized patients for at least 12 months after discharge without their being S. typhi excretors;(5) Vi agglutinin titres as high as 1/40 were present in TAB immunized healthy individuals and also in members of the general public; (6) the presence of S. typhi septicaemia need not result in a high antibody titre; (7) patients who relapse, may do so without enhancement of previous antibody titres and may relapse even in the presence of earlier appreciable titres.

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

“…In 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;…”

“…The limitations of the Widal reaction in the diagnosis of enteric fever during the Aberdeen typhoid outbreak of 1964 (Brodie, 1977) directed attention towards a comparison of methods for antibody titration to ascertain whether or not any method, not employed in the usual diagnostic range, would yield results which might be helpful in diagnosis.…”

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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.

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Bactericidal activity of human sera against <i> Salmonella Typhi</i>and <i>Salmonella paratyphi</i> A,B,C

“…The blood groups of individual donors were determined using commerciallyprepared antisera (Laboratory Diagnostic Products Ltd) as previously described (3,5,18). Altogether, there were 41 females and 55 males, consisting of 20, 16, 6 and 54 of A, B, AB, and O blood groups, respectively.…”

“…Although reports on the baseline Salmonella antibody titre have been documented (18)(19)(20), the role played by A,B,O blood system, complement and immunoglobulins in the bactericidal activity of normal human serum against Salmonella typhi and Salmonella paratyphi A,B,C has not been documented. This study attempts to determine the sensitivity of Salmonella typhi and Salmonella paratyphi A,B,C to normal human serum and the role of complement system and immunoglobulin in bactericidal effect of blood serum.…”