COMPLEMENT FIXATION IN PERTUSSIS 523 



Recently Anna Wessels Williams 1 came to the conclusion that the 

 test with serum of human beings is not as clear cut as it seems to be 

 with serum of animals which have been injected with the bacillus of 

 pertussis. 



Renaux, 2 using the Bacillus pertussis for antigen, examined 73 sera 

 for complement fixation, 32 cases of which were known cases of pertussis. 

 Of the cases of pertussis, he obtained complement fixation in 23. Of 

 the 9 negative cases, the serum had been obtained early during the 

 disease, and 3 of these gave positive complement fixation when the 

 attack had lasted about four weeks. No further examination was made 

 on the remaining 6 cases. His results seem to show that fixation appears 

 about three or four weeks after the appearance of the whoop. 



In 18 cases of pertussis Friedlander and Wagner 3 obtained comple- 

 ment fixation in each case. They used fresh serum of pertussis patients 

 and living bacteria. The Noguchi hemolytic system was used throughout 

 their work on account of the small quantity of serum necessary. They 

 claim that the diagnosis of pertussis can be made with certainty in the 

 catarrhal stage by means of complement fixation. In a more recent 

 article Freidlander 4 reports further results. He obtained fixation in 

 13 of 14 cases in the catarrhal stage before the characteristic whoop 

 had appeared. In one case there was fixation three weeks before the 

 first whoop. W T inholt 5 has reported positive reactions in pertussis 

 with polyvalent antigens prepared by cultivating the bacilli on potato- 

 glycerin blood-agar, suspending in normal salt solution, and heating 

 to 56 C. for thirty minutes. Olmstead and Povitsky 6 have been able 

 to differentiate between Bacillis pertussis and B. influenza by means 

 of the complement-fixation tests employing rabbit immune sera. 



Preparation and Standardization of the Antigen. Antigens may be 

 prepared in the same manner as gonococcus antigen (page 505) and 

 should be polyvalent. The antigen should always be titrated for the 

 anticomplementary unit as described in the gonococcus complement- 

 fixation test, and used in a dose corresponding to one-third the anti- 

 complementary unit. 



The Test. This may be conducted with 0.2 c.c. of serum or with 

 graded doses 0.05, 0.1, and 0.2 c.c. as described under the gonococcus 



1 Arch. Pediat., 1914, 31, p. 567. 



2 Centralbl. f. Bakteriol., I. O., 1914, 75, p. 197. 



3 Amer. Jour. Dis. of Children, 1914, 8, p. 134. 



4 The Lancet-Clinic, 1915, 113, p. 8. 



5 Jour. Infect. Dis., 1915, 16, 389. 



6 Jour. Med. Research, 1916, 33, 379. 



