We thank the authors for their comments about our article [1]. In exercises of determining the cutoff for diagnostic tests, it is inevitable that some amount of misclassification would always happen. We always try to minimize this risk but there is no way to eliminate it altogether. It is thus possible that the published studies, by using the cut-off of OD values of >0.5, would have over-estimated the proportion of Orientia tsutsugamushi infection among probable scrub typhus patients. We also feel that conducting well-planned epidemiological studies to estimate regional cut-offs in scrub typhus endemic area would be challenging without involving credible laboratories. Such studies would need sera from sufficient number of patients with detailed granular data on clinical details from a given region. The feasibility of involving district/state public health laboratories and using previous samples, as suggested by the authors, would therefore need a careful consideration before such studies are initiated. 　

REFERENCES

1. Gupte MD, Gupte M, Kamble S, et al. Detection of immunoglobulin M and immunoglobulin G antibodies against Orientia tsutsugamushi for scrub typhus diagnosis and serosurvey in endemic regions. Indian Pediatr. 2020; S097475591600242.