Nonnegligible Seroprevalence and Predictors of Murine Typhus, Japan (Response)

[...]despite raising the diagnostic cutoff from 1:40 to 1:160, the preeminence of R. typhi seroprevalence persisted over that of Orientia tsutsugamushi (2), the causative agent of scrub typhus, which is the most frequent endemic rickettsiosis in Japan. [...]excluding many persons with distant past infections did not influence the study’s conclusion that R. typhi seroprevalence was significantly higher than that of O. tsutsugamushi. [...]although Dr. Iwata’s commentary is pivotal for a more precise interpretation of our results, our study indicates the occurrence of recent MT cases in Japan. Use of a sensitive microplate enzyme-linked immunosorbent assay in a retrospective serological analysis of a laboratory population at risk to infection with typhus group rickettsiae.