Orientia tsutsugamushi Antibodies in Patients with Eschars and Suspected Tickborne Disease.

To investigate local transmission of Orientia tsutsugamushi by chiggers in North Carolina, USA, we tested remnant serum specimens from patients with eschar undergoing testing for suspected tickborne disease. We identified 11 persons with O. tsutsugamushi antibodies, including 4 who were positive by both assays; none had severe clinical manifestations consistent with scrub typhus.