Widal Test (Tube Agglutination)
Understanding Widal Test (Tube Agglutination)
What is Widal Test (Tube Agglutination)?
The Widal Test (Tube Agglutination) is a blood test that helps diagnose typhoid and paratyphoid fever, collectively named enteric fever. It helps evaluate the level of antibodies produced by the body in response to Salmonella typhi/paratyphi, the bacteria causing typhoid (enteric fever). By detecting these antibodies, the test can confirm or rule out whether or not an individual has been infected with the bacteria that causes typhoid fever.
The Widal Test (Tube Agglutination) test named after its founder Georges Ferdinand Widal, is a serological test that helps diagnose typhoid fever. This bacterial infection typically presents symptoms within 6 to 30 days of exposure, including high fever, fatigue, headache, abdominal pain, diarrhea or constipation, weight loss, and a rash known as “rose spots.” These symptoms can resemble those of other diseases, making accurate diagnosis difficult without proper testing. Early diagnosis and treatment are important to prevent serious complications, such as severe intestinal bleeding or perforation.
The Widal Test (Tube Agglutination) test detects antibodies produced by the body in response to Salmonella typhi antigens - O (somatic) and H (flagellar). This test involves mixing the patient’s blood sample (containing antibodies) with the commercially available stained bacterial antigens and observing for agglutination (clumping) reactions, indicating the presence of specific antibodies. It is suggested to perform this test in the second week of the illness since antibody levels against O and H antigens typically appear in the blood by then. For more reliable results, it is advisable to conduct the test with two blood samples taken 7 to 10 days apart.
Interpretation of test results requires consideration of factors such as the clinical history, vaccination status, and prevalence of typhoid in the region. However, the Widal Test (Tube Agglutination) test has certain limitations and should not be used as a standalone diagnostic test in cases with low antibody titers. It can produce false-positive results due to cross-reactivity with other bacterial infections and false-negatives in early infection or vaccinated individuals. Also, it cannot distinguish between past or current infection. Therefore, it is often combined with other diagnostic methods for a more reliable diagnosis.
No special preparation is required for this test but inform your doctor about all the medications or supplements that you are taking, as they may affect the test results and may require adjustments or temporary discontinuation. Also, provide your vaccination history to help them correlate your clinical and laboratory findings.
Test results may vary across laboratories due to differences in methodology and laboratory guidelines. Do not self-medicate at home solely based on these results and always consult your doctor for proper understanding of the test results. The test results will help the doctor tailor your overall treatment plan.
What is Widal Test (Tube Agglutination) used for?
The Widal Test (Tube Agglutination) test is done:
- To diagnose Typhoid fever (Enteric fever).
- To detect the levels of specific antibodies (O and H) in the blood against Salmonella antigens.
- To monitor the progression and treatment response in individuals diagnosed with typhoid fever.
- In conjunction with other diagnostic tests alongside clinical symptoms to confirm a suspected case of typhoid fever.
- To help doctors choose appropriate antibiotic therapy based on the likelihood of a typhoid infection.
- To help identify outbreaks of typhoid fever in typhoid endemic areas helping in public health interventions.
What does Widal Test (Tube Agglutination) measure?
The Widal Test (Tube Agglutination) measures the levels of specific antibodies in the blood against antigens of the bacteria Salmonella typhi/paratyphi, the causative agents for enteric fever. This test detects agglutinating (clumping) antibodies against two types of antigens: the ‘O’ antigen (somatic) and the ‘H’ antigen (flagellar). A significant elevation in the levels of these antibodies (increased titres) suggests a current or recent infection with Salmonella typhi/paratyphi suggesting enteric fever.
The Widal Test (Tube Agglutination) test is useful for diagnosing typhoid fever in typhoid endemic areas, helping doctors tailor appropriate treatment plans.
Interpreting Widal Test (Tube Agglutination) results
Interpretations
If the antibody against Salmonella is present in patient’s serum, it will react with the respective antigen in the reagent and give visible agglutination (clumping) at the bottom of the test tube after 18 hrs.
The highest dilution of the patient’s serum sample that gives a visible agglutination with the Widal test antigen suspensions is the antibody titre.
The serum sample which shows the titre of 1:80 or more for O agglutination and 1:160 or more for H agglutination indicates active infection. A rise in titres (4-fold or more) in the two blood samples taken 10 days apart confirms the diagnosis. Please note that different labs may have different reference values for the interpretation of the Widal test.
The interpretation of a Widal test is greatly influenced by the nature and extent of the patient’s previous contact with typhoid antigens. It can be either due to clinical or subclinical infection with typhoid or related organisms or from typhoid vaccination. The lesser the extent of the previous contact, the greater is the usefulness of the Widal test.