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NCERT Exemplar · Q3

Q.The clinical test that is used for diagnosis of typhoid is:

(a) ELISA
(b) ESR
(c) PCR
(d) Widal
Manipur CohsemMCQ· 1mImportance★★★★★
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✓ Free question

The Widal test is the standard serological method for diagnosing typhoid fever by detecting antibodies against Salmonella typhi in the patient's serum.

Typhoid fever, caused by the bacterium Salmonella typhi, spreads through contaminated food and water—a persistent public health challenge in regions with inadequate sanitation. When a patient presents with sustained high fever, headache, weakness, and abdominal symptoms, clinicians need a reliable way to confirm whether typhoid is the culprit. This is where diagnostic tests come into play.

The Widal test has been the classical serological diagnostic tool for typhoid for over a century. It works on a straightforward immunological principle: when Salmonella typhi infects the body, the immune system produces specific antibodies against the bacterial antigens. The Widal test detects these antibodies—specifically against the O antigen (somatic) and H antigen (flagellar)—in the patient's serum. A blood sample is mixed with known antigens, and if antibodies are present, visible agglutination (clumping) occurs. The test measures antibody titres, and a significant rise in titre over time, or a single high titre in an endemic area, suggests active infection.

Note

The Widal test isn't perfect—it can give false positives in people previously vaccinated against typhoid or those with past infections, and false negatives early in the disease when antibody levels are still low. Despite these limitations, it remains widely used because it's inexpensive, doesn't require sophisticated equipment, and can be performed in basic laboratory settings across India.

Let's briefly consider why the other options don't fit. ELISA (Enzyme-Linked Immunosorbent Assay) is indeed used to detect antibodies or antigens for various diseases—HIV, hepatitis, dengue—but it's not the standard clinical test specifically associated with typhoid diagnosis in routine practice. ESR (Erythrocyte Sedimentation Rate) is a non-specific marker of inflammation; an elevated ESR tells you something is wrong but doesn't identify typhoid specifically. PCR (Polymerase Chain Reaction) can detect bacterial DNA with high sensitivity and is used in research or specialized settings, but it's not the conventional first-line clinical test for typhoid that you'd find mentioned in standard protocols.

The NCERT textbook, when discussing bacterial diseases and their diagnosis, identifies the Widal test as the diagnostic method for typhoid fever, reflecting its established role in clinical practice across India.

✓Final answer

The Widal test (D) is the clinical diagnostic test for typhoid, detecting antibodies against Salmonella typhi through a simple, cost-effective serological method widely used in endemic regions.

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