(This package insert also used for individual febrile antigens). 5.

5. Place the slide on a mechanical rotator at 80-100 r.p.m.,

MATERIALS NEEDED BUT NOT PROVIDED for 1 minute.
 Pipettes. 6. Read the results immediately in good indirect light
 Sodium Chloride 0.85% NaCl preservative free and light noting the agglutination where visible.
ATLAS FEBRILE ANTIGENS
source.
SLIDE/TUBE TEST Additional requirements for slide tests: B. Slide Titer Test:
 Glass slides. 1. Bring reagents to room temperature.
A qualitative and semi-quantitative test for the detection of  Applicator stick and wax pencil. 2. Using the wax pencil, divide a clean transparent glass
bacterial agglutinins in bacterial infections slide into 5 circles of 3cm in diameter.
Additional requirements for tube tests: 3. Place 80µl, 40µl, 20µl, 10µl, 5µl of test serum (clear &
For In-Vitro diagnostic and professional use only  Test tubes 13x100mm. unheated) into these circles consecutively.
 Tube rack. 4. Shake the antigen well and add one drop onto every
Store at 2 to 8° C  Glass dilution flask. circle. The dilution of the circles are 1:20, 1:40, 1:80,
 Water bath. 1:160, 1:320 respectively. Mix using the applicator stick.
5. Repeat steps 5-6 above.
INTENDED USE PRECAUTIONS
For the qualitative and semi-quantitative detection of bacterial  Reagents should be stored in an upright position and Reading the qualitative results
agglutinins in bacterial infection. refrigerated between 2 to 8º C. Never Freeze.
Results are interpreted according to the degree of
 Reagents should be brought to room temperature and
INTRODUCTION & PRINCIPLES agglutination
mixed well to obtain a uniform suspension of antigens.
Antibodies are formed in human infection cases with various Degree of agglutination Result
 The antigens are intended for In-Vitro diagnostic use only.
microbiological agents. Mixing these antibodies with the 100% in clear 4+
 Always include positive and negative antisera controls as
corresponding homologous antigens causes agglutination under supernatant fluid
well as a saline control in each test procedure.
controlled conditions. The agglutination is macroscopically visible. 75% in slightly 3+
For screening purposes, the antigens can be used in the qualitative PREPARING THE SPECIMEN cloudy fluid
rapid slide test. Positive results can be confirmed with the ATLAS Febrile antigens can be used with serum stored 2 to 8º C. The 50% in moderately 2+
quantitative tube test to verify the antibody titer. test requires serum collected from 5-10 ml of whole blood sample. cloudy supernatant
The serum should be separated quickly to avoid any excess fluid
MATERIALS hemolysis and should not be inactivated. It should also be clear and 25% in cloudy 1+
MATERIALS PROVIDED free from bacterial contamination. supernatant fluid
ATLAS Febrile Kit contains the following antigens: No agglutination Negative.
 Brucella. PROCEDURES
 Proteus. 1. QUALITATIVE PROCEDURES The titer in this method is approximate and determined
 Salmonella O. A. Rapid Slide Test: at 50% agglutination. The quantitative procedure is
 Salmonella H. 1. Bring reagents and samples to room temperature.The more recommended for determining the sample titre.
(All febrile antigens contain phenol 0.5% preservative, except sensitivity of the test may be reduced at low Results should be read at one minute.
Salmonella H antigen which contains formalin 0.5%.) temperatures.
The kit also contains: 2. Place 50 µl of the sample to be tested (Note 1 and 2) 2. SEMI-QUANTITATIVE PROCEDURE
 Positive control antiserum for Brucella abortus, Brucella and 1 drop of each control into separate circles on the 1. Prepare 10 test tubes on a rack.
Melitensis, Salmonella H groups A,B,C,D Salmonella O slide test. 2. In tube 1, add 950µl of NaCl 0.85% solution.
groups A,B,C,D, Proteus OX19, OX2, OXK. 3. Swirl the antigen vial gently before using. Add 1 drop 3. In tubes 2-10, add 500µl of NaCl 0.85% solution.
 Negative control antiserum. (50 µL) of antigen to each circle next to the sample to 4. Place 50µl of the serum sample in tube 1 and mix
The controls are stabilized with glycerine and contain 0.01% be tested . well.
merthiolate. 4. Mix with a stirrer and spread over the entire area 5. Starting from tube 1, prepare a two fold serial
enclosed by the circle . dilutions by transferring 500µl from one tube to the
NOTE
 next tube. Mix well after each transfer. Discard 3. A single positive result has less significance than the Atlas Medical
500ul from the last tube. demonstration of a rising or falling antibodies titer as William James House
6. Repeat step 5 for the positive and negative controls. evidence of infection. A clinical diagnosis should not be Cowley Rd, Cambridge
7. In a new test tube labeled 'Saline Control', place made on findings of a single test result, but should CB4 0WX
500µl of 0.85% NaCl solution. integrate both clinical and laboratory data. Tel: ++44 (0) 1223 858 910
8. Mix the antigens well. 4. A somatic reaction (O) is characterized by coarse, compact Fax: ++44 (0) 1223 858 524
9. Add one drop of antigen to each test tubes and agglutination, which tends to be difficult to disperse, while PPI296A01
shake the rack well. Final serum dilution is 1:20,…, flagellar (H) has a characteristic loose, flocculant Rev H (28.05.2013)
1:10240. agglutination.
10. Incubate the samples in a water bath as follows: Catalogue Number Store at
LIMITATION
For In-Vitro Diagnostic
Antigen Incubation Temperature  In some non-infected cases, non-specific agglutinins may use
Caution
Time appear and react with the Febrile antigens giving false Number of tests in the Read product insert
Salmonella O antigens 24 hours 37C results. pack before use
Salmonella H antigens 24 hour 37C  Some vaccination may also produce agglutinins that react Lot (batch) number Manufacturer
Proteus antigens 24 hours 37C with Febrile antigens resulting in false results.
Brucella antigens 24 hours 37C  Physicians should always evaluate all clinical and Fragile, handle with
Expiry date
care
11. At the end of the incubation period, gently remove the laboratory findings before making a definitive diagnosis.
Manufacturer fax Do not use if
rack from the water bath to avoid disturbing the number package is damaged
suspensions. Disease Antigen Antibody Peak Titer
Manufacturer
12. Examine each tube in turn and observe the Reagent Presence Production
telephone number
agglutination. Interpret the results as in the qualitative Brucellosis B.Abortus 2-3 weaks 3-5 weaks 1:80
test. Paratyphoid Salmonella 2-3 weaks 4-5 weaks 1:80
Fever Flag a
Reading the quantitative results Paratyphoid Salmonella 2-3 weaks 4-5 weaks 1:80
The dilution of the tubes are as follows: Fever Flag b
Rocky Mt. Proteus OX 2-3 weaks 2-3 weaks 1:160
1 2 3 4 5 Spotted fever 19
1:20 1:40 1:80 1:160 1:320 Typhoid fever Typhoid H 2-3 weaks 4-5 weaks 1:80
Typhoid fever Typhoid O 1-2 weaks 4-5 weaks 1:80
6 7 8 9 10
Typhus Proteus OX 1-2 weaks 2-3 weaks 1:160
1:640 1:1280 1:2560 1:5120 1:10240
19
Significant in non-vaccinated individuals
The titer of the sample is read according to the dilution of the test
tube with 2+ (50%) agglutination level. REFERENCES
Repeat the test if there is an agglutination in the saline or the 1. Alton G.G. et. al., 'Laboratory techniques in Brucellosis', 2nd
negative control or if there is no agglutination in the positive control. Ed., WHO, Geneva 1975.
2. Diamond B.E., Pub. Health Lab., V6, 74, 1948.
NOTES 3. Spink W.W. , McCullough N.B. and Hutchings L.H., Amer. J.
1. In some geographical areas with a high prevalence of Clin. Path., 24:486, 1954
febrile antibodies, it is recommended to dilute the sample
1/4 in NaCl 9 g/l before to perform the assay.
2. The incubation procedure may be accelerated incubating as
follows:
 Somatic (O) and Proteus antigens: 48-50C for 4 h.
 Flagellar (H) antigens:48-50C for 2 h.