Japanese Spotted Fever in Korea

Jang and colleagues in 2004 claimed their study to be the first documentation of spotted fever group (SFG) rickettsiosis in Korea and indicated that Japanese spotted fever (JSF) was prevalent in Korea from 1992 to 1993 (1). I believe that some drawbacks exist in their study design and have drawn them to a premature and inadequate conclusion. This study was focused on Korean patients with acute febrile illness from December 1992 to November 1993. The diagnosis was made on the basis of indirect immunofluorescence assay in which only Rickettsia japonica and Orientia tsutsugamushi were used as rickettsial antigens. Overall, 676 (19.88%) out of 3,401 patients were found to have polyvalent antibody at a 1:40 serum dilution against R. japonica. In another study by the same group with the same study design, 546 (16.24%), 482 (14.34%), and 269 (8%) out of 3,362 patients were seropositiv