Early diagnosis of typhoid fever by the detection of salivary IgA

Background/Aims: Current diagnostic methods for typhoid fever have low sensitivity and specificity. This study aimed to develop an enzyme linked immunosorbent assay (ELISA) with greater sensitivity and specificity. Methods: The ELISA was developed and evaluated on patients with acute typhoid infection, febrile controls, and healthy controls. A sequential study on patients with culture confirmed typhoid was also carried out to determine the time period of maximum sensitivity. Results: The ELISA detected anti-Salmonella typhi lipopolysaccharide (LPS) salivary IgA antibodies. A six month follow up study of patients with culture confirmed typhoid fever showed that the test shows maximum efficiency during the second and third weeks of fever and enables detection of the acute infection during the early phase. Conclusions: This ELISA can detect typhoid fever during the early phase of infection and is most efficient during the second and third weeks of fever, the time at which patients normally present for treatment. Because the sensitivity of the assay is subsequently greatly reduced, it will be useful for the diagnosis of acute infection.