Vi serology in the detection of typhoid carriers

A new haemagglutination assay for Vi antibodies was evaluated in searches for symptom-free carriers of Salmonella typhi associated with sporadic cases of typhoid fever. The assay differs from previous ones in that a purified (instead of crude) Vi antigen from Citrobacter was used to sensitise the red blood cells. In ten sporadic outbreaks of typhoid stool culture identified seven enteric carriers of S. typhi among the patients' families or other close contacts. All seven carriers had Vi antibodies in titres ranging from 1:40 to 1:2560. Moreover, among thirty-seven stool-culture-negative contacts of patients, only one had Vi antibodies, in a titre of 1:10. Thus, the new assay for Vi antibodies was as sensitive and as specific as faecal culture in detecting symptom-free typhoid carriers. It could become a convenient screening test.