{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:42:30Z","timestamp":1768812150334,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005918","name":"Christian Medical College, Vellore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005918","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000278","name":"Department for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Scrub typhus is a common cause of fever in Asia. The antibody response to infection and its effect on subsequent infection are unclear. We studied the IgM and IgG antibody response after infection, accounting for clinical severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We studied 197 scrub typhus patients for up to 2\u00a0years post\u2010infection. Overall, 501 blood samples were analysed for scrub typhus antibodies using ELISA. IgM and IgG ELISA optical densities (OD) were analysed using quantile regression. OD values of 1.0 (IgM) and 1.5 (IgG) were used to define seropositivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IgM OD values fell rapidly from an initial peak after infection. 50% of cases were IgM seronegative after 82\u00a0days. About 2\u00a0years after fever onset, 50% of cases had fitted IgG OD values of &lt;1.5. Patients with high initial IgG OD values (\u22652.5, used as a proxy for probable previous scrub typhus infection) had a more sustained IgG response than those with a low initial IgG OD, and more often presented with complications (18\/36\u00a0=\u00a050% <jats:italic>vs.<\/jats:italic> 28\/91\u00a0=\u00a030.8%, risk ratio\u00a0=\u00a01.63, 95% CI 1.04, 2.55, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.035). This association was robust to adjusting for age (risk ratio 1.50, 95% CI 0.96, 2.33, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.072).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cross\u2010sectional IgG seroprevalence data substantially underestimate the proportion in a population ever infected with scrub typhus. A high initial IgG as a potential marker for previous scrub typhus infection may be associated with long\u2010term IgG persistence and a higher risk of complicated scrub typhus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13322","type":"journal-article","created":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T12:14:03Z","timestamp":1572351243000},"page":"1455-1464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Antibody response following scrub typhus infection: clinical cohort study"],"prefix":"10.1111","volume":"24","author":[{"given":"Wolf\u2010Peter","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Christian Medical College Vellore India"},{"name":"Department for Disease Control London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol S.","family":"Devamani","sequence":"additional","affiliation":[{"name":"Department of Rural Unit for Health and Social Affairs Christian Medical College Vellore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winsley","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Pediatric Infectious Diseases Christian Medical College Vellore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Alexander","sequence":"additional","affiliation":[{"name":"MRC Tropical Epidemiology Group London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A. J.","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Christian Medical College Vellore India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1099\/00207713-45-3-589"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.13-0064"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603657"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2205.150953"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(76)90127-9"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1202.050900"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-777X.192966"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003971"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.02.009"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.09.019"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003327"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.06.014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005838"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006062"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2018.03.018"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007160"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12853"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.2016.1121814"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00553-15"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2018.01.018"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1515\/jem-2014-0011"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049475517740310"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002181"},{"key":"e_1_2_7_27_1","first-page":"38","article-title":"Eschar in scrub typhus: a study from North East India","volume":"67","author":"Jamil M","year":"2019","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9062.234626"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-328"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1179\/2047773212Y.0000000001"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/0022-3859.118033"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.264495"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmw027"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2010.09-0233"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.13322","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13322","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13322","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T05:20:26Z","timestamp":1693804826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,27]]},"references-count":33,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/tmi.13322"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13322","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,27]]},"assertion":[{"value":"2019-11-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}