284 The Philippine Journal of Science ms 



THE GRUBLER-WIDAL TEST AT DIFFERENT STAGES OF 

 TYPHOID FEVER 



By Dr. J. S. Hilario 



The diagnosis of infectious diseases by means of agglutina- 

 tion test is one of the most useful means that is available to re- 

 cognize infectious diseases such as typhoid fever. The present 

 paper gives the findings in 818 cases submitted to the Grubler- 

 Widal test, of which 607 were typhoid, 154* were doubtful or 

 suspected typhoid, and 77 were other diseases. Of 818 tests 

 performed, 404 were positive, giving a percentage of 56.8 pos- 

 itive. The test was performed with Bacillus typhosus, B. para- 

 typhosus-A, and B. paratyphosus-B simultaneously on each in- 

 dividual case. During the first week of typhoid infection the 

 percentage positive found was 42.3; during the second week, 

 65.4 ; during the third week, 65.9 ; during the fourth week, 72.8 ; 

 during the seventh week, 100. A series of 440 cases submitted 

 to simultaneous tests with three organisms of the typhoid- 

 paratyphoid group has given the following results : With Bacillus 

 typhosus the positive tests were 52.04 per cent; with B. para- 

 typhosus-B, 30.04 per cent; with B. paratyphosus-A, 9.77 per 

 cent. In a series of 226 positive tests the presence of group- 

 agglutinations among members of the typhoid-paratyphoid group 

 is shown by the following : Group-agglutination between typhosus 

 and paratyphosus-B was found in 44.6 per cent ; between typhosus 

 and paratyphosus-A in 5.3 per cent; and between typhosus, 

 paratyphosus-A and paratyphosus-B in 6.6 per cent. As to 

 diseases other than typhoid the results of the test made were 

 as follows : Of 103 cases of undetermined fever 43 were positive 

 for typhosus, giving an average of 41 per cent; of 4 cases of 

 malaria, 1 was positive for typhosus and 1 for paratyphosus-B ; 

 of 3 cases of pneumonia, 1 was positive for typhosus; of 2 cases 

 of meningitis, 1 was positive for typhosus; of 1 case of pulmon- 

 ary tuberculosis, 1 was positive for typhosus; of 2 cases of 

 bronchopneumonia, both were positive for typhosus; and 1 case 

 of dysentery and 1 case of puerperal fever were also positive for 

 typhosus. In view of the above data, the following conclusions 

 may be established: 



(1) Infection with Bacillus typhosus is the most frequent in 

 Manila, while paratyphoid infections also occur, although not 

 so frequently, the infection with paratyphosus-B being more 

 frequent than that with paratyphosus-A, which is rare. 



(2) Typhoid-paratyphoid-B group-agglutinations are the com- 



