Published online by Cambridge University Press: 15 May 2009
By limiting our cultural investigations to persons who possess appreciable quantities of O agglutinins, we have detected a number of typhoid carriers and there are no indications that any carriers have been missed by following this labour-saving procedure. Several of our carriers were found to possess no H agglutinins.
As, however, O agglutinins occur in persons who are not carriers, and the number of such positive O reactors is increasing through the use of vaccines, the number of cultural examinations where no positive results can be expected is growing at a rate which will gradually make our procedure more difficult of application.
It would seem that Vi agglutination might provide a new and efficient method of narrowing down the field for cultural examinations. Vi agglutinins are very rare in normal persons. We have 4 manifest chronic carriers who possess significant quantities of Vi agglutinins. We have 3 persons who at one time were chronic stool carriers, in whom we now also find significant quantities of Vi agglutinins, but in whom at the time we cannot demonstrate typhoid bacilli. We also have 5 persons who at one time were chronic carriers, who now do not show any Vi agglutinins, and in whom we also at this time cannot find typhoid bacilli. Two of these were urinary carriers, which makes their negative cultural results more significant. Lastly, we have 2 persons who at one time obviously were temporary urinary carriers, and who now have lost their bacilli, and in whom also we now cannot detect Vi agglutinins.
In the search for typhoid carriers negative cultural results carry little weight. Our positive findings support the view that typhoid carriers are characterized by the possession of significant quantities of Vi agglutinins.