{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T20:28:43Z","timestamp":1783715323655,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T00:00:00Z","timestamp":1437523200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["30\/3\/36\/2008\/ECD-II"],"award-info":[{"award-number":["30\/3\/36\/2008\/ECD-II"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbiology and Immunology"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Clinical diagnosis of scrub typhus is often difficult because the symptoms are very similar to those of other febrile illness such as dengue, leptospirosis, malaria and other viral hemorrhagic fevers. Though better diagnostic tests are available for rickettsial diseases and scrub typhus elsewhere, the Weil\u2013Felix test is still commonly used in India, mainly because microimmunofluorescence assays (M\u2010IFA) were not available in India till recently and relevant staff had insufficient training. The present study was performed to investigate the performance of M\u2010IFA, IgM ELISA, and Weil\u2013Felix test on 546 non\u2010repeated serum samples from subjects suspected of having scrub typhus. One hundred and forty\u2010three of these 546 samples were positive by M\u2010IFA; these cases were also confirmed clinically to have scrub typhus based on their dramatic responses to doxycycline therapy. IgM ELISA was positive in 122 of the 143 M\u2010IFA positive cases and the Weil\u2013Felix test in 96. Though the Weil\u2013Felix test is a heterophile agglutination test, it was found in this study to have good specificity but far too little sensitivity to use as a routine diagnostic test. IgM ELISA can be a good substitute for M\u2010IFA. Incorporation of multiple prototype antigens on M\u2010IFA slides is likely one of the reasons for its superior performance. As newer and better diagnostic assays become available for scrub typhus diagnosis in developed countries, it will be imperative to also use such tests in other endemic countries to prevent over\u2010 or under\u2010diagnosis of scrub typhus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1348-0421.12268","type":"journal-article","created":{"date-parts":[[2015,5,25]],"date-time":"2015-05-25T20:01:10Z","timestamp":1432584070000},"page":"371-374","source":"Crossref","is-referenced-by-count":54,"title":["Diagnostic validation of selected serological tests for detecting scrub typhus"],"prefix":"10.1111","volume":"59","author":[{"given":"Munegowda","family":"Koraluru","sequence":"first","affiliation":[{"name":"Department of Microbiology Melaka Manipal Medical College, Manipal Campus, Manipal University, Manipal Udupi Karnataka  576104 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indira","family":"Bairy","sequence":"additional","affiliation":[{"name":"Department of Microbiology Melaka Manipal Medical College, Manipal Campus, Manipal University, Manipal Udupi Karnataka  576104 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidhar","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Medicine Kasturba Medical College, Manipal University Madhav Nagar, Manipal Karnataka 576104 India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Vidyasagar","sequence":"additional","affiliation":[{"name":"Department of Medicine Kasturba Medical College, Manipal University Madhav Nagar, Manipal Karnataka 576104 India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107687807100709"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1983.32.1101"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/CDLI.8.2.409-414.2001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1128\/CDLI.5.4.519-526.1998","article-title":"Expression and refolding of truncated recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi and its use in enzyme\u2010linked immunosorbent assays","volume":"5","author":"Ching W.M.","year":"1998","journal-title":"Clin Diagn Lab Immunol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2002.67.497"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1128\/jcm.11.6.584-588.1980","article-title":"New paper enzyme\u2010linked immunosorbent technique compared with microimmunofluorescence for detection of human serum antibodies to Rickettsia tsutsugamushi","volume":"11","author":"Crum J.W.","year":"1980","journal-title":"J Clin Microbiol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1128\/jcm.9.1.38-48.1979","article-title":"Sensitive microplate enzyme\u2010linked immunosorbent assay for detection of antibodies against the scrub typhus rickettsia, Rickettsia tsutsugamushi","volume":"9","author":"Dasch G.A.","year":"1979","journal-title":"J. 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