The Agglutinin Content of the Blood Following Typhoid and Paratyphoid Immunization

Abstract

Most clinical pathologists have seen patients sent to their hospitals with a diagnosis of typhoid fever because of the presence of an otherwise unexplained fever and a positive Widal test. On further study some of these patients have been found to be suffering from another disease and the Widal reaction has been due to a previous vaccination. The widespread use of vaccination in military, school, and hospital circles, and even in the general population, has multiplied this rather serious source of error in recent years so that controlled observation of the agglutinin reactions of the blood of immunized persons are desirable. Recent literature reveals little information as to the duration or the strength of agglutinins in the blood following vaccination. However, Karl Meyer and Kilgore report persistence of agglutinins for a period of ten months and summarize the literature up to the year 1917. They properly criticize much of the older work because of the technique employed, and the qualitative and quantitative variations of the antigens used both for vaccination and for the agglutination tests. More recently Hoffstadt and Thompson report that in a series of persons immunized by the oral route, agglutinins persisted in a fair proportion of cases for five and fewer for nine months. Tests at later periods following vaccination were not reported by the above authors. Chambers however, tested bloods from a series of war veterans vaccinated at various camps during the war and found appreciable agglutination in about half the cases for as long as thirteen years after inoculation.