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February 28, 1986

The Weil-Felix Test Is Archaic and Misleading

Author Affiliations

Washington County Hospital Association Hagerstown, Md

JAMA. 1986;255(8):1020. doi:10.1001/jama.1986.03370080042021

To the Editor.—  Zuerlein and Smith1 have appropriately recommended that the Widal group of febrile agglutinin tests should be abandoned because of their dismal predictive value. They unfortunately did not heed their own data or the past recommendations of others2-4 also to abandon the equally archaic and misleading Weil-Felix reactions. Numerous studies have clearly demonstrated the lack of sensitivity and specificity exhibited by these tests in the diagnosis of rickettsial disease.While mentioning complement fixation as an alternative test along with direct fluorescent antibody testing of biopsy specimens, the authors appear to be unaware of a much more sensitive and specific test now available, the microimmunofluorescent test.5 This test is available, usually with a 24- to 48-hour turnaround time, from most of the larger commercial reference laboratories. It is an indirect fluorescent antibody test that utilizes either a single dilution (screening test) or multiple dilution (quantitative titer)