A Battery of Serological Tests for the Differentiation of Primary Typhus Fever From It’s Recrudescent and Their Occurence in Bosnia and Herzegovina
DOI:
https://doi.org/10.5644/Radovi.108Abstract
From September 1964 to July 1967 serologically has been tested 2.148 sera obtained from 237 patients. At the Clinic for infectious disease in Sarajevo or from the practising doctors in the others areas of SR Bosnia and Herzegovina these cases of disease have been diagnosed as classical primary typhus (80 cases); recrudescent typhus (116 cases) and 41 cases for which couldn’t be determined whether they belong to the classical primary typhus or to his recrudescent.
By use of “battery” of tests (CF test with 2 and 8 units of antigen and with sera inactivated at 56° C and 60° C; C. F. test with and without the addition of 2-imercaptoethanol and Weil-Felix test), and by use of special epidemiological inquiry in field for every of those cases of disease, 33 case of primary (13,92 percent), 155 cases of recrudescent typhus fever (65,40 percent) and 49 cases (20,61 percent) “undetermined” has been established.
This study shows that in Bosnia and Herzegovina many cases of Brill-Zinsser diseases are wrongly diagnosed as primary classical typhus.
The sera of primary typhus fever give higher endtitters with 8 antigen units instead with 2 units and also higher titters with sera inactivated at the 56° C instated at 60° C. 2-mercaptoethanol destroys the antibodies of primary typhus fever. In Brill-Zinsser diseases this difference does not exist.
In 20,67 percent of cases even with “batery” of serological tests the differentiation between primary and recrudescent typhus could not be made. The author believes that new serological tool for the diagnosis of typhus fever reinfection has to be found. Since a case of Brill-Zinsser disease can, in a very lousy environment, provoke a case or cases of primary typhus fever the same method of control measures have to be taken in case of Brill-Zinsser disease as in case of primary typhus fever.
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