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Sera referred to the North Carolina Division of Health Services for rickettsial serology in 1974 were tested by complement fixation (CF), microimmunofluorescence (micro-IF), microagglutination (MA) and hemagglutination (HA) for antibodies against Rickettsia rickettsii. There was good agreement among micro-IF,MA and HA tests in detecting antibody responses to this agent, but the CF test was definitely less sensitive than the others, even in illnesses with classical clinical manifestations of Rocky Mountain spotted fever (RMSF). Some variables that seemed to influence the CF result were the slow rate of increase in antibody titers, timing of serum collection, early antibiotic treatment and possibly, the particular association of CF antibody response with the IgG immunoliobulin class. Greater use of these newer, but relatively untried, serodiagnostic procedures is recommended infuture studies of RMSF.
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