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Figure 1 shows antibody titers by time between onset and sample collection, based on HI assays for all 267 samples.
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†Time between rash onset and sample collection.
The median interval between fever onset and sample collection was 4 days (range 2 9).
Among close contacts with symptomatic infection, the median interval between illness onset and sample collection was 0.5 days.
The period between illness onset and sample collection ranged from 0 days to 10.1 years (median 31 days).
For the 601 symptomatic index case-patients, the median interval between illness onset and sample collection was 1.0 days (range −1.9 to 7.0 days).
The greater the number of days between symptom onset and sample collection, the more difficult it is to detect a causative agent.
Furthermore, the fact that all patients were treated as inpatients allowed us to standardize important variables that could affect the validity of our results such as the time between fever onset and sample collection.
Second, some misclassification of the cases caused by the sensitivity and specificity of the tests or to a time lag between symptom onset and sample collection (i.e., PCR- or IgM-negative results caused by testing intervals that were too long or too short, respectively) cannot be ruled out.
The time interval between fever onset and sampling varied between the patients, and they did not necessarily have respiratory tract symptoms.
Both age and time between disease onset and sampling were adjusted for in our calculations confirming the association between bacterial load and disease severity.
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