Typhoid

test pdf

Jko typhoid pretest. Ctk typhoid test procedure pdf.

Tst test for typhoid.

A Widal test meaning is a sersology blood test that helps detect typhoid or enteric fever in the body. This test was first conducted in 1896 by Georges Ferdinand Widal and was named after him. The Widal test is an advanced way to check for antibodies that your body makes against the salmonella bacteria that causes typhoid fever. It looks for O and
H antibodies in a patient’s sample blood (serum).
This test helps detect life-threatening illnesses like typhoid fever. However, interpreting the Widal test is important to arrive at the correct results. Keep reading this blog to understand the meaning of the Widal test, its principle, procedure, and test result interpretation. Typhoid Fever and Widal Test Typhoid fever, also known as enteric fever, is a
severe illness caused by salmonella bacteria. This bacteria affects your digestive system after you consume food or water contaminated with faecal material. A person with typhoid fever will experience symptoms like fatigue, high fever, headache, diarrhoea or constipation, abdominal pain, weight loss, and red spots. It is crucial to detect and treat
typhoid fever as soon as possible to prevent further complications like severe intestinal bleeding or perforation.
There are various tests available to detect typhoid fever, such as stool culture, bone marrow, etc. One such test is the Widal test, which detects the presence of antibodies that your body makes against salmonella bacteria during typhoid. The bacteria that causes typhoid fever is Salmonella bacteria. It can spread from person to person or from
consuming contaminated food. The bacteria are of two types: Salmonella Typhi, also known as S. Typhi, Salmonella Paratyphi, which is also known as S. Paratyphi Now, the bacteria S. Typhi has two antigens named: S. Typhi O (TO), primary antigen S. Typhi H (TH), secondary antigen On the other hand, the bacteria S. Paratyphi has the following two
antigens: S. Paratyphi A S. Paratyphi B To understand and interpret the Widal test reports, we will discuss these values later in this blog to understand and interpret the Widal test reports. Principle of Widal Test When you consume food contaminated with salmonella bacteria, it enters your body in the form of antigens. After reaching your digestive
system, your immunity creates antibodies against those antigens. As a result, antigens agglutinate (react), and typhoid fever is detected. This agglutination test detects the antibodies your body has made in response to a particular bacteria or antigen. If you have typhoid fever, your sera (blood) will possess antibodies that will react and agglutinate
salmonella antigens in an agglutination test. The main Widal test principle is that if a particular antibody is present in the serum, it will react with a specific antigen and show visible clumping on the test card. The following step of this test measures the titre of the positive antigen: Preparation of Widal Test Slide Widal Test To prepare for a Widal
test, we would require the following objects: Patient’s serum Pipette (lab tool) Serum S.

Antigen ( O, H, AH, BH) Slide Mix Stick Stopwatch You will also need reagents to detect antigens like O Ag (somatic or surface Ag), H Ag (flagella), AH Ag, BH Ag, etc. The Widal test procedure is carried out in two steps: For this test, you will use a slide with 6 reaction circles, marked as O, H, AH, BH, PC and NC. To begin with, Put one drop of the
patient’s serum in four reaction circles, i.e., O, H, AH, BH. Add one drop of positive control in the PC circle and one in the NC circle. Next, add one drop of O antigen in the O circle, P antigen in the P circle, AH antigen in the AH circle, and BH antigen in the BH circle, respectively. Add any antigen, i.e., O, H, AH, BH in both PC and NC. Next, mix the
serum and antigen in each circle properly so that the mixture doesn’t go out of the circle and touch the slide.

Also, one mixture should not mix with another, as it can influence the test results. Finally, rotate the slide in a slow circular motion to ensure a proper mixture of serum and reagent.
Once everything is done, you can see the results. If the test is positive, the test will be similar to the PC (+ve control circle), and if it’s negative, it will be similar to NC (-ve control circle). In other words, if there is any agglutination, the test results will be positive and vice versa. Now, if the test results are positive, the next stage will involve a
quantitative test.
To confirm the diagnosis of typhoid fever, we will take the reagent of the antigen that is positive. For example, if O was positive in the qualitative test, we will take the O reagent in the quantitative test. In most cases, O and H, i.e., S. Typhi are used to confirm the diagnosis. Only a few people have their AH or BH positive during a qualitative test. 2. A
quantitative Widal test: It is a semi-procedure test, which means you will check for O if O is positive, H if H is positive, and both if both are positive. To perform this test, follow these steps: Use a different slide with 8 circles: four for O antigen and four for H. Now, if O was positive in the last test, put 5 ul patient’s serum in the 1st O circle, 10 ul in the
2nd, 20 ul in the 3rd, and 40 ul in the 4th circle horizontally. In the same way, put one drop of the specific reagent in all four circles. To report, mark the values from the right side. Mark 1:40 on the fourth circle, 1: 80 on the 3rd circle, 1:160 on the 2nd, and 1:320 on the 1st circle. Interpretation of Widal Test-Slide Method After mixing the serum and
reagent properly and rotating the slide, wait for the results to show. The result will be positive if it shows positive in more than 100 in the O circle and 200 in the case of H. In other words, it is a positive Widal test if the titre is above 100 in O and 200 in H. However, the results can be negative due to antibiotics, malaria, dengue, or the fever has
affected you for more than a few days, etc. You can interpret your test results in the following ways: Negative if S. Typhi is smaller than or equal to 1:80 and positive if S. Typhi is more than or equal to 1:160. Negative if S.
Paratyphi is smaller than or equal to 1:80 and positive if S. Paratyphi is more than or equal to 1:160. If S. Typhi O is positive, then you have an active fever. However, in the case of positive S. Typhi H, the fever is a past infection. Moreover, the Widal test normal range is when the titre is equal to or below 1:80 in both O and H antigens. Tube Widal
Test Apart from qualitative and quantitative Widal tests, there is another test method; the standard tube method. Here, eight tubes are taken, diluted and observed. The first test can screen for typhoid fever; however, a tube Widal test effectively confirms a fever. Originally, two types of tubes were used to detect typhoid fever: Dreyer’s tube for H
agglutination Felix tube for O agglutination Nowadays, 3 x 0.5 ml Kahn tubes are used for both O and H agglutination.
Process of Standard Tube Method: To prepare for a Widal test, we would require the following objects: Patient’s serum O, H, AH and BH Antigens Normal Saline Pipette Test Tube Rack Test Tubes Water Bath Before beginning this test, it is essential to note that the tube method is a dilution technique that has to be done correctly. Let’s understand
this test in a simpler language.

First, take nine tubes and arrange them in the rack. In the case of O, mark the tubes in numbers from 1 to 9. Add and mix 0.1 ml normal saline and 0.9 ml serum in the first test tube. On the other hand, add 0.5 normal salines to each remaining tube. Next, take 0.5 ml from the 1st tube and add in the second. This will result in 0.5 ml remaining solution
in test tube 1 and 1 ml in test tube 2nd. Repeat this process i.e., take 0.5 ml from the last tube and add it to the next tube to make it 1 ml. With the 8th tube, take 0.5 ml and keep that in another separate tube.
Mix all the tubes properly. This will give us primary serial dilution of all the tubes from 1st to 8th as 1:10, 1:20, 1:40, 1:80, 1:160, 1:320, 1:640, and 1:1280, respectively. Take a new (9th) test tube and add positive control. Next, add 0.5 ml of respective antigen (O, H, AH, BH) in all eight tubes. This will make the final volume of each tube 1 ml. After
adding a reagent to all the tubes, we will have the final serial dilution of all the tubes from 1st to 8th as 1:20, 1:40, 1:80, 1:160, 1:320, 1:640, 1:1280, 1:2580. Now, mix well, cover and incubate the tubes at 37° C overnight (18 to 24 hours). Interpretation of Widal Test-Tube Method If you have typhoid fever and there is some agglutination, you will see
that the 9th tube (positive control) will look similar to one of the eight other tubes. If there is no enteric fever, there will be no change in the normal range of the eight tubes and widal test. If the tube that showed agglutination has a titre of more than 1:100 in case of O and 1: 200 in H, it will be widal test positive (active infection). Other than this, rest
titers are considered the normal range of a widal test. Limitations of Widal Test No doubt, the widal test is a quick and effective way to diagnose typhoid fever, but it has some limitations as well, including: The results of the Widal test can be falsely positive in the case of past vaccination or S. Typhi infection. The Widal test is time-consuming; until a
diagnosis is made, it becomes too late to start the treatment. A widal test can not distinguish between a patient’s past infection, current infection, or a S. Typhi vaccination.
The test results can be falsely positive in typhus, acute falciparum malaria, chronic liver disease, rheumatoid arthritis, nephrotic syndrome and myelomatosis. Because so many factors can influence the test results, it is better to not just depend on this test for typhoid diagnosis. However, it is always best to choose trustable labs regarding screening. A
delay or ineffective screening can cause a delay in the treatment. Price of Widal Test A widal test is a quick and affordable test which is mostly used in developing countries where typhoid fevers are prevalent. The widal test cost can differ based on location, lab centre and other criteria. With Metropolis Labs, the cost of the widal test is just xxx. Our
website features allow you to track your sample, download reports, book a home visit, upload prescriptions, etc. Contact metropolis labs today to book a widal test and get results quickly. Conclusion A Widal test is a quick procedure to diagnose typhoid fever or enteric fever. It only requires a patient’s serum and some reagents to detect this fever.
However, because different factors can influence the test results, it is always best to perform this test one week after the infection, following proper instructions. If you have typhoid fever or are experiencing its symptoms, you can book a Widal test today. Like Like Love Haha Wow Sad Angry Widal Test is an agglutination test which detects the
presence of serum agglutinins (H and O) in patients serum with typhoid and paratyphoid fever.When facilities for culturing are not available, the Widal test is the reliable and can be of value in the diagnosis of typhoid fevers in endemic areas.It was developed by Georges Ferdinand Widal in 1896.The patient’s serum is tested for O and H antibodies
(agglutinins) against the following antigen suspensions (usually stained suspensions):S. Typhi 0 antigen suspension, 9, 12S. Typhi H antigen suspension, dS. Paratyphi A 0 antigen suspension, 1, 2, 12S. Paratyphi A H antigen suspension, aS. Paratyphi B 0 antigen suspension, 1, 4, 5, 12S. Paratyphi B H antigen suspension, b, phase 1S. Paratyphi C 0
antigen suspension, 6, 7S.
Paratyphi C H antigen suspension, c, phase 1Salmonella antibody starts appearing in serum at the end of first week and rise sharply during the 3rd week of endemic fever. In acute typhoid fever, O agglutinins can usually be detected 6–8 days after the onset of fever and H agglutinins after 10–12 days.It is preferable to test two specimens of sera at an
interval of 7 to 10 days to demonstrate a rising antibody titre.Salmonella antigen suspensions can be used as slide and tube techniques.Bacterial suspension which carry antigen will agglutinate on exposure to antibodies to Salmonella organisms. Patients’ suffering from enteric fever would possess antibodies in their sera which can react and
agglutinate serial doubling dilutions of killed, colored Salmonella antigens in a agglutination test.The main principle of widal test is that if homologous antibody is present in patients serum, it will react with respective antigen in the reagent and gives visible clumping on the test card and agglutination in the tube. The antigens used in the test are “H”
and “O” antigens of Salmonella Typhi and “H” antigen of S. Paratyphi. The paratyphoid “O” antigen are not employed as they cross react with typhoid “O” antigen due to the sharing of factor 12. “O” antigen is a somatic antigen and “H” antigen is flagellar antigen.H suspension of bacteria is prepared by adding 0.1 per cent formalin to a 24 hours
broth culture or saline suspension of an agar culture.For preparation of O suspensions of bacteria, the organisms is cultured on phenol agar (1:800) to inhibit flagella.Standard smooth strains of the organism are used; S Typhi 901, O and H strains are employed for this purpose.The growth is then emulsified in small volume of saline, mixed with 20
times its volume of alcohol, heated at 40° C to 50° C for 30 minutes and centrifuged.The antigens are treated with chloroform (preservative) and appropriate dyes are added for easy identification of antigens.Place one drop of positive control on one reaction circles of the slide.Pipette one drop of Isotonic saline on the next reaction cirlcle. (-ve
Control).Pipette one drop of the patient serum tobe tested onto the remaining four reaction circles.Add one drop of Widal TEST antigen suspension ‘H’ to the first two reaction circles.
(PC & NC).Add one drop each of ‘O’, ‘H’, ‘AH’ and ‘BH’ antigens to the remaining four reaction circles.Mix contents of each circle uniformly over the entire circle with separate mixing sticks.Rock the slide, gently back and forth and observe for agglutination macroscopically within one minute.Pipette one drop of isotonic saline into the first reaction
circle and then place 5, 10, 20, 40, 80 ul of the test sample on the remaining circles.Add to each reaction circle, a drop of the antigen which showed agglutination with the test sample in the screening method.Using separate mixing sticks, mix the contents of each circle uniformly over the reaction circles.Rock the slide gently back and forth, observe
for agglutination macroscopically within one minute.In Widal Test, two types of tubes were originally used:(1) Dreyer’s tube (narrow tube with conical bottom) for H agglutination and(2) Felix tube (short round-bottomed tube) for O agglutination.Now a days 3 x 0.5 ml Kahn tubes are used for both types of agglutination.Take 4 sets of 8 Kahn tubes/test
tubes and label them 1 to 8 for O, H, AH and BH antibody detection.Pipette into the tube No.1 of all sets 1.9 ml of isotonic saline.To each of the remaining tubes (2 to 8) add 1.0 ml of isotonic saline.To the tube No.1 tube in each row add 0.1 ml of the serum sample to be tested and mix well.Transfer 1.0 ml of the diluted serum from tube no.1 to tube
no.2 and mix well.Transfer 1.0 ml of the diluted sample from tube no.2 to tube no.3 and mix well. Continue this serial dilution till tube no.7 in each set.Discard 1.0 ml of the diluted serum from tube No.7 of each set.Tube No.8 in all the sets, serves as a saline control. Now the dilution of the serum sample achieved in each set is as follows: Tube No. : 1
2 3 4 5 6 7 8 (control) Dilutions 1:20 1:40 1:80 1:160 1:320 1:640 1:1280.To all the tubes (1 to 8) of each set add one drop of the respective WIDALTEST antigen suspension (O, H, AH and BH) from the reagent vials and mix well.Cover the tubes and incubate at 37° C overnight (approximately 18 hours).Dislodge the sedimented button gently and
observe for agglutination.Above protocols are obtained from WIDAL TEST: Swemed DiagnosticsAgglutination is a positive test result and if the positive reaction is observed with 20 ul of test sample, it indicates presence of clinically significant levels of the corresponding antibody in the patient serum.No agglutination is a negative test result and
indicates absence of clinically significant levels of the corresponding antibody in the patient serum.The titre of the patient serum using Widal test antigen suspensions is the highest dilution of the serum sample that gives a visible agglutination.The sample which shows the titre of 1:100 or more for O agglutinations and 1:200 or more for H
agglutination should be considered as clinically significant (active infection). Example: In the above figure, titre is 160.Demonstration of 4-fold rise between the two is diagnostic.H agglutination is more reliable than O agglutinin.Agglutinin starts appearing in serum by the end of 1st week with sharp rise in 2nd and 3rd week and the titre remains
steady till 4th week after which it declines.The Widal test is time consuming (to find antibody titre) and often times when diagnosis is reached it is too late to start an antibiotic regimen.The Widal test should be interpreted in the light of baseline titers in a healthy local population.The Widal test may be falsely positive in patients who have had
previous vaccination or infection with S. Typhi.Besides cross-reactivity with other Salmonella species, the test cannot distinguish between a current infection and a previous infection or vaccination against typhoid.Widal titers have also been reported in association with the dysgammaglobulinaemia of chronic active hepatitis and other autoimmune
diseases.False positive Widal test results are also known to occur in typhus, acute falciparum malaria(particularly in children), chronic liver disease associated with raised globulin levels and disorders such as rheumatoid arthritis, myelomatosis and nephrotic syndrome.False negative results may be associated with early treatment, with “hidden
organisms” in bone and joints, and with relapses of typhoid fever.
Occasionally the infecting strains are poorly immunogenic.False negative Widal tests may be due to antibody responses being blocked by early antimicrobial treatment or following a typhoid relapse.Severe hypoproteinaemia may also prevent a rise in 0 and H antibody titres.The antibody levels found in a healthy population however, may vary from
time to time and in different areas, making it difficult to establish a cut off level of baseline antibody in a defined area and community.In low typhoid endemic areas, weak and delayed O and H antibody responses limit the usefulness of the Widal test.
Variations also exist between laboratories in the performance and reading of Widal tests which compromise further the reliability of the test.The World Health Organization (WHO) has said that due to the various factors that can influence the results of a Widal test, it is best not to rely too much on this test.Similar Posts:Normal Laboratory Values of
Blood, Plasma, Serum, Urine, CSF and StoolRapid Plasma Reagin (RPR) Test for the diagnosis of SyphilisAntigen- Properties, Types and Determinants of AntigenicityCoombs Test- Principle, Types, Procedure and Result Interpretation Vijaya Diagnostic Centre Plot no 2A,Street No.1,Kakatiya Nagar, Habsiguda,Hyderabad-500007.Helpline : 040-
21000000 LABORATORY TEST REPORT 14:13:3/12/2019Regn DateSample Collection:12/03/2019 14:15:Print Date Name15:2014/03/2019: MRS. RANI :Regn No/: 86190034 Age / Sex Female42 Years :Regn CentreMoula-AliRef By:SELFSample Type :SerumRef no.: WIDAL TEST TEST NAMERESULTBIOLOGICAL REFERENCE INTERVALWidal Test
NAPositive : . Salmonella typhi O 1 : 160 :Salmonella typhi H 1 : 20 :Salmonella paratyphi AH Less than 1 : 20 :Salmonella paratyphi BH Less than 1 : 20 : Method : Slide Agglutination Interpretation :----------------------------------------------------------------------------------------------------------------------------------------------------------RESULT TITRE INTERPRETATION---------------------
------------------------------------------------------------------------------------------------------------------------------------- Negative 1:80 Specimen is Positive for Widal test / Presence of antibodies to Salmonella. ----------------------------------------------------------------------------------------------------------------------------------------------------------* This test is for the quantitative detection of antibodies to Salmonella
in serum of patients with symptoms suspicious of enteric fever.* The result of this test should be correlated clinically and with other Laboratory findings of patient.* Individuals vaccinated with Typhoid vaccine (TAB) may show moderately elevated titres of all three "H" antibodies.* Confirmation by Blood culture and sensitivity if the patient is not on
antibiotics.
SUPRAJA BIOCHEMIST Released Date 12/03/2019 17:54 Page 1 of 3 Vijaya Diagnostic Centre Plot no 2A,Street No.1,Kakatiya Nagar, Habsiguda,Hyderabad-500007.Helpline : 040-21000000 LABORATORY TEST REPORT 14:13:3/12/2019Regn DateSample Collection:12/03/2019 14:15:Print Date Name15:2014/03/2019: MRS. RANI :Regn No/:
86190034 Age / Sex Female42 Years :Regn CentreMoula-AliRef By:SELFSample Type :Whole Blood - EDTARef no.: COMPLETE BLOOD PICTURE (CBP) TEST NAMERESULTBIOLOGICAL REFERENCE INTERVALHaemoglobin 12.0 - 15.0 g/dL12.7 : Photometric measurement Total RBC Count 3.8 - 4.8 millions/cumm4.58 : Coulter Principle Packed
Cell Volume / Hematocrit 36.0 - 46.0 Vol%38.60 : Calculated MCV 83.0 - 101.0 fl84.20 : Derived from RBC Histogram MCH 27 - 32 pg27.80 : Calculated MCHC 31.5 - 34.5 gm/dL33.00 : Calculated RDW 11.6 - 14.0 %13.5 : Calculation Total WBC Count 4000 - 10000 Cells/cumm4700 : Coulter Principle Differential countNeutrophils 40 - 80 %50 :
VCSn Technology & Microscopy Lymphocytes 20 - 40 % :41 VCS Technology & Microscopy Eosinophils 1 - 6 %1 : VCS Technology & Microscopy Monocytes 2 - 10 %8 : VCS Technology & Microscopy Basophils 0 - 2 %0 : VCS Technology & Microscopy Absolute Leucocyte CountAbsolute Neutrophil Count 2000 - 7000 Cells/cumm2350 : Method :
Calculation Absolute Lymphocyte Count 1000 - 3000 Cells/cumm1927 : Method : Calculation Absolute Eosinophil Count 20 - 500 Cells/cumm47 : Method : Calculation Absolute Monocyte Count 200 - 1000 Cells/cumm376 : Method : Calculation Released Date 12/03/2019 17:41 Page 2 of 3