Clinical evidence1 of infection and lab confirmation using:
- Serological evidence of a fourfold change in IgG titer reactive with Rickettsia2 antigen by indirect immunofluorescence assay (IFA) between paired serum specimens (one taken in the first week of illness and a second 2-4 weeks later)
- Detection of Rickettsia2 nucleic acid in a clinical specimen via amplification of a specific target by PCR assay
- Demonstration of Rickettsia2 antigen in a biopsy or autopsy specimen by IHC
- Isolation of Rickettsia2 from a clinical specimen in cell culture.
1 Clinical evidence: Any reported fever and one or more of the following: rash, headache, myalgia, anemia, thrombocytopenia, or any hepatic transaminase elevation.
2 Rickettsial infections include Rickettsia typhi (Typhus), Rickettsia rickettsia (Rocky Mountain Spotted Fever), Ehrlichia sp. (Ehrlichiosis) and Anaplasma phagocytophilum (Anaplasmosis)