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To elucidate the epidemiology of murine typhus, which is infrequently reported in Japan, we conducted a cross-sectional study involving 2,382 residents of rickettsiosis-endemic areas in Honshu Island during August–November 2020. Rickettsia typhi seroprevalence rate was higher than that of Orientia tsutsugamushi, indicating that murine typhus is a neglected disease.

The article focuses on the potential reemergence of murine typhus in Japan, challenging the conclusion drawn from a study indicating a high seroprevalence rate for Rickettsia typhi in residents on Honshu Island. It author suggests that the study's cross-sectional nature and the absence of consideration for historical cases might lead to premature conclusions about the reemergence of murine typhus in Japan.