Enteric Fevers and Normal Salmonella Agglutinins in the Gold Coast

Abstract

SummaryEnteric fevers are common in the Gold Coast, where their incidence is increasing owing to insanitary urbanization. Children and migrant labourers form the bulk of the patients. Typhoid fever accounts for three-quarters of the cases, but paratyphoid A and paratyphoid C also occur. The Widal test has attained renewed importance in early diagnosis since the introduction of chloramphenicol, and gave a presumptive diagnosis within 24 hr. in two-thirds of the cases. ‘Normal’ agglutinin levels were determined in 200 sera sent for the Kahn test, and provide data for interpreting the Widal test in the Gold Coast. Low titre H agglutinins in the sera of normal people are thought to indicate past vaccination or infection, but low titre O agglutinins are probably unrelated to either. Agglutination of a Salm. typhi H suspension by normal sera suggests that one adult African in eight in the Gold Coast has suffered from typhoid fever.I have to thank Lt. Col. H. J. Bensted, O.B.E., M.C., for kindly providing Standard agglutinating sera.My thanks are also due to Messrs D. Gellatly, A.I.M.L.T., K. C. Lisle, E. S. Martinson and A. T. Nartey for their technical assistance at various times during the past 2½ years.I am indebted to Dr George Watt, M.B.E., acting Chief Medical Officer, Gold Coast, for permission to publish this paper.