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The Widal Test is a serological agglutination test that detects antibodies produced by the immune system against Salmonella typ...
Also known as: Widal Test · Widal Agglutination Test · Typhoid Antibody Test · Enteric Fever Serology
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The Widal Test is a serological agglutination test that detects antibodies produced by the immune system against Salmonella typhi and Salmonella paratyphi antigens in blood — used to support the diagnosis of typhoid fever (enteric fever). The Slide Method provides a rapid semi-quantitative result by observing agglutination on a glass slide. The Widal test has been widely used in India for typhoid diagnosis for over a century — though it has significant limitations including false positives in endemic areas and from other infections. It is being progressively replaced by more specific tests such as Typhidot IgM (Test 72) and blood culture. No fasting required.
Key benefits of this package include:
What Does the Widal Test (Slide Method) Measure?
| Level / Result | Possible Interpretation |
|---|---|
| All titres below threshold | No significant Salmonella antibodies — typhoid less likely in this clinical context |
| O antigen ≥ 1:80 (or endemic threshold) | Elevated O antibody — may indicate active or recent S. typhi infection; clinical correlation essential |
| H antigen ≥ 1:160 (or endemic threshold) | Elevated H antibody — may indicate typhoid or prior exposure/vaccination; less specific than O titre alone |
| Both O and H elevated above threshold | Most suggestive of active typhoid — but false positives are common in endemic areas; confirm with Typhidot or blood culture |
| 4-fold titre rise between paired sera 7–10 days apart | Strongest Widal evidence for active typhoid — rising titre confirms ongoing antibody response to active infection |
Important Note: The Widal test has high false-positive rates in typhoid-endemic areas — most of India. Cross-reactions occur with other Salmonella species, non-typhoid Salmonella infections, malaria, dengue, liver disease, and previous typhoid vaccination. A single positive Widal titre should never alone be used to diagnose typhoid — clinical symptoms, fever pattern, and preferably Typhidot IgM or blood culture confirmation are required. Many clinical guidelines in India now de-emphasise the Widal test due to its poor specificity in endemic settings.
Widal Test vs. Typhidot vs. Blood Culture — The Hierarchy of Evidence for Typhoid: Blood Culture: Gold standard — identifies S. typhi with 100% specificity; sensitivity 40–80% (lower if antibiotics already started). Most useful in the first week of fever. Typhidot IgM (Test 72): Detects S. typhi-specific IgM antibodies with high specificity (~85–90%) — superior to Widal; single sample sufficient; available from Day 4–7 of fever. Widal Test: Non-specific agglutination test; high false-positive rate in endemic areas; requires paired sera for meaningful interpretation. Use Widal only when Typhidot and blood culture are unavailable.
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Screens for anaemia, infections, and immune health
