{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:47Z","timestamp":1787031167925,"version":"build-2736575974"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,1]]},"abstract":"<jats:p>\n                    Among 13 suspected Rocky Mountain spotted fever (RMSF) cases identified through an enhanced surveillance program in Tennessee, antibodies to\n                    <jats:italic>Rickettsia rickettsii<\/jats:italic>\n                    were detected in 10 (77%) patients using a standard indirect immunofluorescent antibody (IFA) assay. Immunoglobulin M (IgM) antibodies were observed for 6 of 13 patients (46%) without a corresponding development of IgG, and for 3 of 10 patients (30%) at least 1 year post-onset. However, recent infection with a spotted fever group rickettsiae could not be confirmed for any patient, based on a lack of rising antibody titers in properly timed acute and convalescent serologic specimens, and negative findings by polymerase chain reaction testing. Case definitions used in national surveillance programs lack specificity and may capture cases that do not represent current rickettsial infections. Use of IgM antibodies should be reconsidered as a basis for diagnosis and public health reporting of RMSF and other spotted fever group rickettsiae in the United States.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.14-0123","type":"journal-article","created":{"date-parts":[[2014,8,5]],"date-time":"2014-08-05T02:27:27Z","timestamp":1407205647000},"page":"767-770","source":"Crossref","is-referenced-by-count":44,"title":["Inadequacy of IgM Antibody Tests for Diagnosis of Rocky Mountain Spotted Fever"],"prefix":"10.4269","volume":"91","author":[{"given":"Jennifer H.","family":"McQuiston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleb","family":"Wiedeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Singleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Rand","family":"Carpenter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"McElroy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Mosites","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abelardo 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Rickettsia, Proteus spp. and Legionella spp. in patients with Mediterranean spotted fever","volume":"11","author":"Raoult","year":"1995"},{"key":"R12","series-title":"J Clin Microbiol","first-page":"455","article-title":"Comparison of western immunoblotting and microimmunofluorescence for diagnosis of Mediterranean spotted fever","volume":"30","author":"Teysseire","year":"1992"},{"key":"R13","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1527","article-title":"Immunological arousal during acute Q fever infection","volume":"30","author":"Vardi","year":"2011"},{"key":"R14","series-title":"Clin Diagn Lab Immunol","first-page":"324","article-title":"Kinetics of antibody responses in Rickettsia africae and Rickettsia conorii infections","volume":"9","author":"Fournier","year":"2002"}],"container-title":["The American Society of Tropical Medicine and 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