THE WIDAL AGGLUTINATION RE-

ACTION IN HEALTHY PERSONS.

By A. N. BOSE,

MAJOR, I.M.S.,

Professor of Pathology,

and

S. K. GHOSH DASTIDAR, m.b., d.t.m. (Bengal).

(Prom the Department of Pathology, Prince of Wales Medical College, Patna.)

Various authors have referred to the

relative immunity of the inhabitants of the

tropics to the typho-coli group of organisms. This immunity, it has been argued, is due to infection in childhood or to repeated small inoculations with infected food and' drinks at an early period of life. Many observa- tions have be.en made 011 the persistence of

agglutinins that develop in the blood after

protective inoculations. According to Wade McDaniel 11-7 per cent, of cases give a positive Widal reaction after one year from the inocula- tion. But no Indian data are available re-

garding the presence of agglutinins in healthy individuals, or regarding the persistence of the agglutinins in the blood after an attack of enteric fever or dysentery.

June, 1928.J WIDAL REACTION: BOSE AND DASTIDAR. 321

Infections from the organisms of this

group are quite common in Bihar. Both

sexes and all ages are affected. It was of

interest, therefore, to study the agglutinat- ing property of the blood in apparently healthy Indians who had not been protected Previously, especially in an area where the

Sections from the typho-coli group of

organisms are so prevalent. We selected 100 apparently healthy indivi-

duals from different classes, viz., 12 of them from the medical students who live in the

college hostel in A, 42 from the professional class of people who live under ordinary sanitary conditions in B, and 46 from the poorer classes who usually work as servants and day labourers and live under questionable hygienic surroundings in C. Dreyer's technique with Oxford standard

agglutinable culture was employed for these tests. The standard technique does not give

serum reaction in dilutions 1 : 12-5 and *: 83, and for these titres we improvised a simple Method; for the former the serum was dilu- ted to 1 : 5 instead of 1: 10 and 10 drops of it were put up with 15 drops of standard

agglutinable culture; for t'he latter 3 drops serum diluted to 1: 10 were put up with

' drops of saline and 15 drops of the standard culture added.

Table I.

Agglutination Reaction expressed in Serum Dilutions.

Organism.

typhosus .?

Paratyphosus A

Paratyphosus B

dysenterise, Shiga

dyscnterice, Flexner

Negative.

94

96

97

100

100

+ i_ 12'5 +"25 +_1

50

1

83 +

]

~12S Total.

100

100

100

100

100

Reference to Table I shows that 6 per cent.

9/ apparently healthy individuals had ? typhosus agglutinins, 4 per cent, had B.

PorcLtyphosiis A agglutinins, and 3 per cent, had B. paratyphosus B agglutinins; whereas n?ne had B. dysenteries agglutinins (Shiga and Flexner). It is remarkable to note that ^5 per cent, of Col. Megaw's control cases

Rave a positive reaction to Flexner organisms ln dilutions of 1: 40 and over, and 5 per cent. to Shiga organisms in dilution of 1 : 40.

Of 6 cases with typhoid agglutinins only 1 case, who gave a history of continuous fever

30 days three months before, 'had 23 units, three cases between 4 and 5, and two between and 3 units; of 4 cases with Paratyphosus A

Agglutinins one had between 4 and 5 and

three between 2 and 3 units; of 3 cases with Paratypliosus B agglutinins one had between 4 and 5 and two between 2 and 3 units.

Reference to Table II shows that all cases with positive agglutinins, except one belong- ing to group B, occurred in the individuals of

group C who usually live under unsatisfac-

tory hygienic conditions. We shall take up in our next paper the

subject of the persistence of agglutinins in

persons after a definite previous infection

from one of the organisms of the typho-coli group.

Conclusions.

1. Healthy individuals belonging to the

middle class in Bihar do not as a rule show

any agglutinins of the typho-coli group. 2. The few individuals who do show their

presence belong to the poorer classes who live under unsatisfactory 'hygienic condi- tions.

3. There is a remarkable absence of B. dysenteries (Shiga and Flexner) agglutinins in all.

4. The comparative immunity to typho- coli organisms in persons living in tropical countries, referred to by so many observers, does not appear to be due to the presence of

specific agglutinins in large numbers of indivi-

duals and may perhaps be due to some non- demonstrable protective factors in the serum other than agglutinins.

References.

(1) Rogers (1919). Fevers in the Tropics, 3rd Edi- tion.

(2) Manson-Bahr (1925). Tropical Diseases, 8th Edition.

(3) Stitt (1922). Tropical Diseases, 4th Edition. (4) Castellani and Chalmers (1919). Manual of

Tropical Medicine, 3rd Edition. (5) Annual Hospital Reports (1923 and 1924) of

Bihar and Orissa, published by the Inspector-General of Civil Hospitals.

(6) Megaw, J. W. D. Indian Medical Gazette, Vol. 56, No. 9.

322 THE INDIAN MEDICAL GAZETTE.

Table II

.

Aggl

utin

atio

n Reaction i

n Different Gr

oups

of In

dian

s.

B. typhosus.

Group

A

B

C

Neg.

12

41

41

+J_

12*5

1 +i

s +-

.1

50

1 83

0

0

I

0

+ iz

V T ota

l.

12

42

46

B paratyphosus A.

Neg

12

42

42

1

12'5

0

0 3

1 25

0

0

1

Tota

l.

12

42

46

B. paratyphosus

B.

Nes

12

42

43

+Ws\ +i

k ! To

tal.

12

42

46

Shig

a.

Neg.

12

42

46

Posi

- ti

ve.

Total.

12

42

46

Flexner.

1\ eg.

12

42

46

Posi-

tive

. To

tal.

12

42

46