This is a useful assay for the diagnosis of Rickettsial diseases in which sera are tested for agglutinins to ‘O’ antigens of Proteus strains OX 19, 2 & K. Rickettsiae are fastidious bacterial organisms that are maintained in nature through a cycle involving reservoirs in mammals and insect vectors. The antibody appears rapidly during the course of the disease, reaches a high titer by the second week & declines rapidly during convalescence. A four fold rise in titer is diagnostic of Rickettsial infection.