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Narasimhan S, Cibichakravarthy B, Wu MJ, Holter MM, Walsh CA, Goodrich JA. Laboratory Management of Mammalian Hosts for Ixodes scapularis -Host-Pathogen Interaction Studies. Comp Med 2024; 74:235-245. [PMID: 39289828 PMCID: PMC11373684 DOI: 10.30802/aalas-cm-24-036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/19/2024] [Accepted: 07/10/2024] [Indexed: 09/19/2024]
Abstract
Due to their hematophagous life cycle, hard-bodied ticks including the genus Ixodes are a potential vector for numerous pathogenic organisms including bacteria, protozoa, viruses, and infectious prions. The natural geographic range of several hard tick species, includig Ixodes scapularis, has expanded over recent decades. Consequently, there is an ongoing need to maintain, feed, and propagate ticks for host-pathogen interaction studies to better understand and mitigate their impact on human and animal health. Artificial membrane feeding of hard ticks has advanced in recent years, has study design advantages, and should be used, when possible, to reduce animal use, but it also has several limitations that require the continued use of mammalian hosts including mice, guinea pigs, and rabbits. In this overview, we discuss the best management practices for these relevant species with respect to biosafety, health, and optimal host comfort when used in studies that depend on tick feeding. The capsule-jacket method is preferred over the ear sock-E-collar method of tick feeding on rabbit hosts because of better host health, comfort, and increased study versatility.
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Affiliation(s)
- Sukanya Narasimhan
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; and
| | | | - Ming-Jie Wu
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; and
| | - Marlena M Holter
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Courtney A Walsh
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
| | - James A Goodrich
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
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Abstract
Our understanding of free-living bacterial models like Escherichia coli far outpaces that of obligate intracellular bacteria, which cannot be cultured axenically. All obligate intracellular bacteria are host-associated, and many cause serious human diseases. Their constant exposure to the distinct biochemical niche of the host has driven the evolution of numerous specialized bacteriological and genetic adaptations, as well as innovative molecular mechanisms of infection. Here, we review the history and use of pathogenic Rickettsia species, which cause an array of vector-borne vascular illnesses, as model systems to probe microbial biology. Although many challenges remain in our studies of these organisms, the rich pathogenic and biological diversity of Rickettsia spp. constitutes a unique backdrop to investigate how microbes survive and thrive in host and vector cells. We take a bacterial-focused perspective and highlight emerging insights that relate to new host-pathogen interactions, bacterial physiology, and evolution. The transformation of Rickettsia spp. from pathogens to models demonstrates how recalcitrant microbes may be leveraged in the lab to tap unmined bacterial diversity for new discoveries. Rickettsia spp. hold great promise as model systems not only to understand other obligate intracellular pathogens but also to discover new biology across and beyond bacteria.
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Affiliation(s)
- Brandon Sit
- Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Rebecca L. Lamason
- Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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Rodríguez-Durán A, Ullah S, Parizi LF, Ali A, da Silva Vaz Junior I. Rabbits as Animal Models for Anti-Tick Vaccine Development: A Global Scenario. Pathogens 2023; 12:1117. [PMID: 37764925 PMCID: PMC10536012 DOI: 10.3390/pathogens12091117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Studies evaluating candidate tick-derived proteins as anti-tick vaccines in natural hosts have been limited due to high costs. To overcome this problem, animal models are used in immunization tests. The aim of this article was to review the use of rabbits as an experimental model for the evaluation of tick-derived proteins as vaccines. A total of 57 tick proteins were tested for their immunogenic potential using rabbits as models for vaccination. The most commonly used rabbit breeds were New Zealand (73.8%), Japanese white (19%), Californians (4.8%) and Flemish lop-eared (2.4%) rabbits. Anti-tick vaccines efficacy resulted in up to 99.9%. Haemaphysalis longicornis (17.9%) and Ornithodoros moubata (12.8%) were the most common tick models in vaccination trials. Experiments with rabbits have revealed that some proteins (CoAQP, OeAQP, OeAQP1, Bm86, GST-Hl, 64TRP, serpins and voraxin) can induce immune responses against various tick species. In addition, in some cases it was possible to determine that the vaccine efficacy in rabbits was similar to that of experiments performed on natural hosts (e.g., Bm86, IrFER2, RmFER2, serpins and serine protease inhibitor). In conclusion, results showed that prior to performing anti-tick vaccination trials using natural hosts, rabbits can be used as suitable experimental models for these studies.
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Affiliation(s)
- Arlex Rodríguez-Durán
- Centro de Biotecnologia, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil; (A.R.-D.); (S.U.); (L.F.P.)
- Programa de Pós-Graduação em Ciências Veterinária, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9090, Porto Alegre 91540-000, RS, Brazil
- Grupo de Investigación Parasitología Veterinaria, Laboratorio de Parasitología Veterinaria, Universidad Nacional de Colombia, Carrera 45 No. 26-85, Bogotá 110911, Colombia
| | - Shafi Ullah
- Centro de Biotecnologia, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil; (A.R.-D.); (S.U.); (L.F.P.)
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan 23200, Khyber Pakhtunkhwa, Pakistan;
| | - Luís Fernando Parizi
- Centro de Biotecnologia, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil; (A.R.-D.); (S.U.); (L.F.P.)
| | - Abid Ali
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan 23200, Khyber Pakhtunkhwa, Pakistan;
| | - Itabajara da Silva Vaz Junior
- Centro de Biotecnologia, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil; (A.R.-D.); (S.U.); (L.F.P.)
- Faculdade de Veterinária, Universidade Federal do Rio Grande de Sul, Avenida Bento Gonçalves, 9090, Porto Alegre 91540-000, RS, Brazil
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular (INCT-EM), Rio de Janeiro 21941-853, RJ, Brazil
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Zhang X, Chen J, Jiang P, Xu H, Zhang Q, Zhang H, Han X, Chen Z. A Phi29-based unbiased exponential amplification and genotyping approach improves pathogen detection in tick samples. Front Vet Sci 2022; 9:1025911. [DOI: 10.3389/fvets.2022.1025911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Ticks are vectors for many infectious diseases, such as spotted fever group (SFG) rickettsioses and borreliosis, and are valuable in the study of pathogen ecology. Ticks have several growth stages that vary considerably in size; therefore, in most cases, DNA extracted from ticks is insufficient for subsequent studies, particularly for multiple pathogen screening and genotyping. Unbiased amplification of DNA from tick samples before analysis is a major requirement for subsequent ecological surveys and other studies. Phi29 DNA polymerase, an enzyme that exhibits strand displacement activity, can exponentially amplify DNA randomly, generating large quantities of DNA. In the present study, we developed a Phi29-based unbiased exponential amplification (PEA) assay to obtain sufficient tick DNA for genetic analysis. By using tick-borne pathogen detection and genotyping as a model, we tested and evaluated the feasibility of the assay. DNA was extracted from single ticks and subjected to PEA. The results showed that tick DNA could be amplified up to 105 fold. The amplified products were successfully used for pathogen screening and genotyping. Rickettsia was successfully detected and genotyped in samples with amplified DNA from single ticks. Furthermore, we identified a new genotype of Rickettsia from ticks collected from Dandong city, Liaoning province, Northeast China. This PEA assay is universal and can be extended to other applications where the quantity of DNA is greatly limited.
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Stokes JV, Levin ML, Cross CE, Ross AL, Snellgrove AN, Willeford BV, Alugubelly N, Varela‐Stokes AS. Evaluating the Clinical and Immune Responses to Spotted Fever Rickettsioses in the Guinea Pig-Tick-Rickettsia System. Curr Protoc 2022; 2:e584. [PMID: 36383032 PMCID: PMC9828190 DOI: 10.1002/cpz1.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The guinea pig was the original animal model developed for investigating spotted fever rickettsiosis (SFR). This model system has persisted on account of the guinea pig's conduciveness to tick transmission of SFR agents and ability to recapitulate SFR in humans through clinical signs that include fever, unthriftiness, and in some cases the development of an eschar. The guinea pig is the smallest animal model for SFR that allows the collection of multiple blood and skin samples antemortem for longitudinal studies. This unit provides the basic protocols necessary to establish, maintain, and utilize a guinea pig-tick-Rickettsia model for monitoring the course of infection and immune response to an infection by spotted fever group Rickettsia (SFGR) that can be studied at biosafety level 2 (BSL-2) and arthropod containment level 2 (ACL-2); adaptations must be made for BSL-3 agents. The protocols cover methods for tick feeding and colony development, laboratory infection of ticks, tick transmission of Rickettsia to guinea pigs, and monitoring of the course of infection through clinical signs, rickettsial burden, and immune response. It should be feasible to adapt these methods to study other tick-borne pathogens. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Tick transmission of SFGR to guinea pigs Support Protocol 1: Laboratory infection of ticks by injection Alternate Protocol 1: Needle inoculation of SFGR to guinea pigs Basic Protocol 2: Monitoring the course of guinea pig rickettsial infection: clinical signs Basic Protocol 3: Monitoring the course of guinea pig rickettsial infection: collection of biological specimens Support Protocol 2: Guinea pig anesthesia Basic Protocol 4: Monitoring rickettsial burden in guinea pigs by multiplex qPCR Basic Protocol 5: Monitoring guinea pig immune response to infection: blood leukocytes by flow cytometry Basic Protocol 6: Monitoring immune response to guinea pig rickettsial infection: leukocyte infiltration of skin at the tick bite site by flow cytometry Basic Protocol 7: Monitoring the immune response to guinea pig rickettsial infection: antibody titer by ELISA Support Protocol 4: Coating ELISA Plates Alternate Protocol 2: Monitoring immune response to guinea pig rickettsial infection: antibody titer by immunofluorescence assay.
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Affiliation(s)
- John V. Stokes
- Department of Comparative Pathobiology, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - Michael L. Levin
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Claire E. Cross
- Department of Pathology, Microbiology, and ImmunologyVanderbilt UniversityNashvilleTennesseeUSA
| | - Anne‐Marie L. Ross
- Department of Comparative Biomedical SciencesMississippi State UniversityMississippi StateMississippiUSA
| | - Alyssa N. Snellgrove
- Division of Vector‐Borne DiseasesCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Bridget V. Willeford
- Laboratory Animal ResourcesMississippi State UniversityMississippi StateMississippiUSA
| | | | - Andrea S. Varela‐Stokes
- Department of Comparative Pathobiology, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
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Ross AML, Stokes JV, Cross CE, Alugubelly N, Varela-Stokes AS. Multiplex TaqMan® Quantitative PCR Assays for Host-Tick-Pathogen Studies Using the Guinea Pig-Tick-Rickettsia System. Pathogens 2022; 11:pathogens11050594. [PMID: 35631115 PMCID: PMC9147651 DOI: 10.3390/pathogens11050594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 12/04/2022] Open
Abstract
Spotted Fever Rickettsiosis (SFR) is caused by spotted fever group Rickettsia spp. (SFGR), and is associated with symptoms common to other illnesses, making it challenging to diagnose before detecting SFGR-specific antibodies. The guinea pig is a valuable biomedical model for studying Spotted Fever Rickettsiosis (SFR); its immune system is more like the human immune system than that of the murine model, and guinea pigs develop characteristic clinical signs. Thus, we have a compelling interest in developing, expanding, and optimizing tools for use in our guinea pig-Amblyomma-Rickettsia system for understanding host-tick-pathogen interactions. With the design and optimization of the three multiplex TaqMan® qPCR assays described here, we can detect the two SFGR, their respective primary Amblyomma sp. vectors, and the guinea pig model as part of controlled experimental studies using tick-transmission of SFGR to guinea pigs. We developed qPCR assays that reliably detect each specific target down to 10 copies by producing plasmid standards for each assay target, optimizing the individual primer-probe sets, and optimizing the final multiplex reactions in a methodical, stepwise fashion. We anticipate that these assays, currently designed for in vivo studies, will serve as a foundation for optimal SFGR detection in other systems, including fieldwork.
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Affiliation(s)
| | - John V. Stokes
- Correspondence: (J.V.S.); (A.S.V.-S.); Tel.: +1-662-769-7191 (J.V.S.); +1-662-769-7192 (A.S.V.-S.)
| | | | | | - Andrea S. Varela-Stokes
- Correspondence: (J.V.S.); (A.S.V.-S.); Tel.: +1-662-769-7191 (J.V.S.); +1-662-769-7192 (A.S.V.-S.)
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Cross CE, Stokes JV, Alugubelly N, Ross AML, Willeford BV, Walker JD, Varela-Stokes AS. Skin in the Game: An Assay to Monitor Leukocyte Infiltration in Dermal Lesions of a Guinea Pig Model for Tick-Borne Rickettsiosis. Pathogens 2022; 11:pathogens11020119. [PMID: 35215063 PMCID: PMC8878158 DOI: 10.3390/pathogens11020119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Intact, the skin typically serves as an effective barrier to the external world; however, once pathogens have breached this barrier via a wound, such as a tick bite, the surrounding tissues must recruit immune cells from the blood to neutralize the pathogen. With innate and adaptive immune systems being similar between the guinea pig and human systems, the ability of guinea pigs to show clinical signs of many infectious diseases, and the large size of guinea pigs relative to a murine model, the guinea pig is a valuable model for studying tick-borne and other pathogens that invade the skin. Here, we report a novel assay for assessing guinea pig leukocyte infiltration in the skin. Briefly, we developed an optimized six-color/eight-parameter polychromatic flow cytometric panel that combines enzymatic and mechanical dissociation of skin tissue with fluorescent antibody staining to allow for the immunophenotyping of guinea pig leukocytes that have migrated into the skin, resulting in inflammation. We designed this assay using a guinea pig model for tick-borne rickettsiosis to further investigate host–pathogen interactions in the skin, with preliminary data demonstrating immunophenotyping at skin lesions from infected ticks. We anticipate that future applications will include hypothesis testing to define the primary immune cell infiltrates responding to exposure to virulent, avirulent tick-borne rickettsiae, and tick-borne rickettsiae of unknown virulence. Other relevant applications include skin lesions resulting from other vector-borne pathogens, Staphylococcus aureus infection, and Buruli ulcer caused by Mycobacterium ulcerans.
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Affiliation(s)
- Claire E. Cross
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA; (C.E.C.); (J.V.S.); (N.A.); (A.-M.L.R.)
| | - John V. Stokes
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA; (C.E.C.); (J.V.S.); (N.A.); (A.-M.L.R.)
| | - Navatha Alugubelly
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA; (C.E.C.); (J.V.S.); (N.A.); (A.-M.L.R.)
| | - Anne-Marie L. Ross
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA; (C.E.C.); (J.V.S.); (N.A.); (A.-M.L.R.)
| | - Bridget V. Willeford
- Laboratory Animal Resources, Mississippi State University, Mississippi State, MS 39762, USA; (B.V.W.); (J.D.W.)
| | - Jamie D. Walker
- Laboratory Animal Resources, Mississippi State University, Mississippi State, MS 39762, USA; (B.V.W.); (J.D.W.)
| | - Andrea S. Varela-Stokes
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA; (C.E.C.); (J.V.S.); (N.A.); (A.-M.L.R.)
- Correspondence: ; Tel.: +1-662-769-7192
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Zaldívar Y, Hernández M, Domínguez L, Saénz L, Montilla S, de Antinori MEB, Krawczak FS, Bermúdez S. Isolation of Rickettsia rickettsii in Rocky Mountain Spotted Fever Outbreak, Panama. Emerg Infect Dis 2021; 27:1245-1247. [PMID: 33755006 PMCID: PMC8007289 DOI: 10.3201/eid2704.201606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report new cases of Rocky Mountain spotted fever in patients from Kinkantu, Ngäbe-Bugle indigenous comarca, Panama. We isolated Rickettsia rickettsii in cell culture after intraperitoneal inoculation of guinea pigs with tissues from a deceased patient. Our results indicate that Rocky Mountain spotted fever is emerging in this region.
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Karim S, Kumar D, Budachetri K. Recent advances in understanding tick and rickettsiae interactions. Parasite Immunol 2021; 43:e12830. [PMID: 33713348 DOI: 10.1111/pim.12830] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 12/31/2022]
Abstract
Ticks are haematophagous arthropods with unique molecular mechanisms for digesting host blood meal while acting as vectors for various pathogens of public health significance. The tick's pharmacologically active saliva plays a fundamental role in modulating the host's immune system for several days to weeks, depending on the tick species. The vector tick has also developed sophisticated molecular mechanisms to serve as a competent vector for pathogens, including the spotted fever group (SFG) rickettsiae. Evidence is still inadequate concerning tick-rickettsiae-host interactions and saliva-assisted transmission of the pathogen to the mammalian host. Rickettsia parkeri, of the SFG rickettsia, can cause a milder version of Rocky Mountain spotted fever known as American Boutonneuse fever. The Gulf Coast tick (Amblyomma maculatum) often transmits this pathogenic rickettsia in the USA. This review discusses the knowledge gap concerning tick-rickettsiae-host interactions by highlighting the SFG rickettsia and the Am maculatum model system. Filling this knowledge gap will provide a better understanding of the tick-rickettsiae-host interactions in disease causation, which will be crucial for developing effective methods for preventing tick-borne diseases.
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Affiliation(s)
- Shahid Karim
- Center for Molecular and Cellular Biosciences, School of Biological. Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Deepak Kumar
- Center for Molecular and Cellular Biosciences, School of Biological. Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Khemraj Budachetri
- Center for Molecular and Cellular Biosciences, School of Biological. Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, USA.,The Ohio State University, Columbus, OH, USA
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Isolate-Dependent Differences in Clinical, Pathological, and Transcriptional Profiles following In Vitro and In Vivo Infections with Rickettsia rickettsii. Infect Immun 2021; 89:IAI.00626-20. [PMID: 33495273 PMCID: PMC8090960 DOI: 10.1128/iai.00626-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
Rickettsia rickettsii, the etiological agent of Rocky Mountain spotted fever (RMSF), a life-threatening tick-borne disease that affects humans and various animal species, has been recognized in medicine and science for more than 100 years. Isolate-dependent differences in virulence of R. rickettsii have been documented for many decades; nonetheless, the specific genetic and phenotypic factors responsible for these differences have not been characterized. Rickettsia rickettsii, the etiological agent of Rocky Mountain spotted fever (RMSF), a life-threatening tick-borne disease that affects humans and various animal species, has been recognized in medicine and science for more than 100 years. Isolate-dependent differences in virulence of R. rickettsii have been documented for many decades; nonetheless, the specific genetic and phenotypic factors responsible for these differences have not been characterized. Using in vivo and in vitro methods, we identified multiple phenotypic differences among six geographically distinct isolates of R. rickettsii, representing isolates from the United States, Costa Rica, and Brazil. Aggregate phenotypic data, derived from growth in Vero E6 cells and from clinical and pathological characteristics following infection of male guinea pigs (Cavia porcellus), allowed separation of these isolates into three categories: nonvirulent (Iowa), mildly virulent (Sawtooth and Gila), and highly virulent (Sheila SmithT, Costa Rica, and Taiaçu). Transcriptional profiles of 11 recognized or putative virulence factors confirmed the isolate-dependent differences between mildly and highly virulent isolates. These data corroborate previous qualitative assessments of strain virulence and suggest further that a critical and previously underappreciated balance between bacterial growth and host immune response could leverage strain pathogenicity. Also, this work provides insight into isolate-specific microbiological factors that contribute to the outcome of RMSF and confirms the hypothesis that distinct rickettsial isolates also differ phenotypically, which could influence the severity of disease in vertebrate hosts.
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