Serological diagnosis of typhoid fever : a review of the limitations of the Widal test

Abstract

Typhoid fever remains an infectious disease of major importance worldwide. Even in developed countries, sporadic outbreaks continue to occur, often localised around a single origin -an asymptomatic carrier or an infected food source particularly shellfish. The severity of presentation, potential life-threatening complications as well as the serious side-effects of the antibiotics used in its treatment necessitates prompt and accurate diagnosis. The only definite diagnostic investigation remains the isolation of Salmonella typhi from samples of blood, bone marrow, faeces, bile and urine. Nevertheless serological tests are still commonly requested in the form of the Widal reaction.