An update on the epidemiological situation of spotted fever in Brazil

A long-term study on free-ranging jaguar-tick interactions, featuring a novel report of Amblyomma incisum adult infestation

Over nearly 12 years, we collected ticks from free-ranging jaguars (Panthera onca) and performed statistical analyses to comprehend the vector-host relationship throughout the seasons. We evaluated the presence and number of ticks, as well as their association with weight, age, and gender of captured jaguars in the Pantanal and Amazon biomes. Out of 100 captured jaguars (comprising 72 initial captures and 28 recaptures, with 41 females and 31 males), 77 were found to be infested by different tick species. We gathered a total of 1,002 ticks, categorized by the following species in descending order of abundance: Amblyomma sculptum, Amblyomma ovale, Rhipicephalus microplus, Amblyomma triste, Amblyomma cajennense sensu stricto, Amblyomma incisum, and Amblyomma spp. larvae. Apart from weight, statistical analysis indicated that age, gender and seasonality does not significantly affect the presence of different tick species in free ranging jaguars. Notably, A. sculptum adults were more abundant in the first semester, while A. sculptum nymphs and Amblyomma spp. larvae were mainly found during dry months, aligning with their expected life cycle stages. This is the first long-term study in jaguars to correlate seasonality and host factors and also the first time an adult of A. incisum is reported infesting a jaguar.

Effect of environmental variables on the abundance of Amblyomma ticks, potential vectors of Rickettsia parkeri in central Brazil

Amblyomma ticks are vectors of both Rickettsia rickettsii and R. parkeri in the Americas, where capybaras (Hydrochoerus hydrochaeris) are the main hosts in urban areas, thus contributing to the transmission of spotted fever. Herein, we studied: (i) the seasonal dynamics and abundance of ticks in areas where capybaras live, (ii) the effect of environmental variables on tick abundance, and (iii) the presence of Rickettsia-infected ticks. Between September 2021 and September 2022, we sampled ticks using cloth-dragging at 194 sites on the shore of Lake Paranoá in Brasília, Brazil. We measured environmental data (season, vegetation type, canopy density, temperature, humidity, and presence or vestige of capybara) at each site. Nymphs and adults were morphologically identified to the species level, and a selected tick sample including larvae was subjected to genotypic identification. We investigated Rickettsia-infected ticks by PCR (gltA, htrA, ompB, and ompA genes) and associations between tick abundance and environmental variables using Generalized Linear Models. A total of 30,334 ticks (96% larvae) were captured. Ticks were identified as Amblyomma, with A. sculptum comprising 97% of the adult/nymphs. Genotype identification of a larval sample confirmed that 95% belonged to A. dubitatum. Seasonal variables showed significant effects on tick abundance. Most larvae and nymphs were captured during the early dry season, while the adults were more abundant during the wet season. Vegetation variables and the presence of capybaras showed no association with tick abundance. Rickettsia parkeri group and R. bellii were identified in A. dubitatum, while A. sculptum presented R. bellii. We conclude that: (i) Amblyomma ticks are widely distributed in Lake Paranoá throughout the year, especially larvae at the dry season, (ii) the abundance of Amblyomma ticks is explained more by climatic factors than by vegetation or presence of capybaras, and (iii) A. dubitatum ticks are potential vectors of R. parkeri in Brasília.

Density and behavior of capybara (Hydrochoerus hydrochaeris) ticks (Acari: Ixodidae) Amblyomma sculptum and Amblyomma dubitatum with notes on Rickettsia bellii infection: Assessing human exposure risk

In several urban and peri‑urban areas of Brazil, populations of Amblyomma sculptum and Amblyomma dubitatum ticks are maintained by capybaras (Hydrochoerus hydrochaeris). In some of these areas, this host and these tick species are associated with Brazilian spotted fever (BSF), a lethal human disease caused by the bacterium Rickettsia rickettsii. In this work, we evaluated the risk of human exposure to these tick species using four collection techniques to discern host-seeking behavior. The study was carried out in 10 urban sites inhabited by capybaras in Uberlândia, a BSF-free municipality in southeastern Brazil. Ticks were collected in areas of 400 m2 at each site and at three seasons. Within the same municipality, the distance and speed of A. sculptum nymphs moving towards the CO2 traps were evaluated. In a sample of ticks Rickettsia DNA was investigated. During the study period, 52,953 ticks were collected. Among these, 83.4 % were A. sculptum (1,523 adults, 10,545 nymphs and 32,104 larvae) and 16.6 % were A. dubitatum (464 adults, 2,153 nymphs and 6,164 larvae). An average annual questing tick density of 4.4/m² was observed, with the highest density recorded at one site in autumn (31.8/m²) and the lowest in summer at another site (0.03/m²). The visual search yielded the highest proportion of A. sculptum larvae, constituting 47 % of the total and 63.6 % of all A. sculptum larvae. In contrast, CO2 traps collected a greater proportion of nymphs and adults of A. sculptum ticks. In the case of A. dubitatum, the CO2 trap was the most efficient technique with 57.7 % of captures of this species, especially of nymphs (94.5 % of captures) and adults (97.8 % of captures). Ticks' ambush height on vegetation (9 to 77 cm), observed by visual search 30 times, yielded a total of 20,771 ticks. Of these, 28 (93 %) were A. sculptum ticks, with only two (7 %) identified as A. dubitatum ticks. Among A. sculptum ticks, the nymph was the most attracted stage to humans and larva in the case of A. dubitatum. Amblyomma sculptum adults and nymphs were significantly more attracted to humans than those of A. dubitatum, but A. dubitatum larvae were significantly more attracted than the same stage of A. sculptum. The maximum distance and speed of horizontal displacement for A. sculptum nymphs were five meters and 2.0 m/h, respectively. The only species of Rickettsia detected in ticks, exclusively in A. dubitatum, was R. bellii. Importantly, it was observed that the higher the proportion of A. sculptum in the community of ticks, the lower the rate of infection of A. dubitatum by R. bellii. In conclusion, host-seeking behavior differed between the two tick species, as well as between stages of the same species. A greater restriction of A. dubitatum ticks to the soil was observed, while larvae and nymphs of A. sculptum dispersed higher in the vegetation. The behavior presented by A. sculptum provides greater opportunities for contact with the hosts, while A. dubitatum depends more on an active search for a host, the hunter behavior. Taken together, these observations show that a human being crossing an area infested with A. sculptum and A. dubitatum ticks will have almost exclusive contact with A. sculptum larvae and/or nymphs. Humans in a stationary position (sitting, lying or immobile) are exposed to both tick species, but they are more attractive to adults and mainly nymphs of A. sculptum compared to the corresponding stages of the tick A. dubitatum. The negative effect of A. sculptum on A. dubitatum infection by R. bellii deserves further studies.

Survey of Rickettsia spp. in ticks (Acari: Ixodidae) infesting opossums (Didelphis albiventris) and capybaras (Hydrochoerus hydrochaeris) from an urban park in southeastern Brazil

Ticks are hematophagous arthropods and, during feeding, may transmit pathogens to vertebrate hosts, including humans. This study aimed to investigate the presence of Rickettsia spp. in ticks collected between 2010 and 2013 from free-ranging capybaras (Hydrochoerus hydrochaeris) and opossums (Didelphis albiventris) that inhabit Sabiá Park in Uberlândia, Brazil. Overall, 1,860 ticks were collected: 1,272 (68.4%) from capybaras (487 of the species Amblyomma sculptum, 475 adults and 12 nymphs; 778 Amblyomma dubitatum, 727 adults and 51 nymphs; and seven larva clusters of the genus Amblyomma); and 588 (31.6%) from opossums (21 A. sculptum, one adult and 20 nymphs; 79 A. dubitatum, all nymphs; 15 Ixodes loricatus, 12 adults and three nymphs; 457 Amblyomma sp. larva clusters; 15 Ixodes sp. larva clusters; and one Argasidae larva cluster). Out of 201 DNA samples tested for the presence of Rickettsia spp. DNA using polymerase chain reaction (PCR) 12 showed amplification of a gtlA gene segment that was specific to Rickettsia bellii, a bacterium non-pathogenic to humans. As there has been a report showing serological evidence of infections caused by Rickettsia species of the spotted fever group (SFG) in capybaras and opossums in the park, including Rickettsia rickettsii, the etiological agent of Brazilian spotted fever, and considering the presence of A. sculptum ticks, which are aggressive to humans, as well as these vertebrate hosts, which are amplifiers of R. rickettsii, it is important to monitor the presence of SFG rickettsiae in the Sabiá Park, which is visited daily by thousands of people.

First report of Amblyomma sculptum (Amblyomma cajennense complex) in a Brazilian state classified as a silent area for human rickettsiosis

Background and Aim

Studies on ticks of public health concern in equine husbandry are scarce in the Northeastern region of Brazil. This study aimed to investigate the presence of ticks on horses in the State of Alagoas, which is classified as a silent area for human rickettsiosis.

Materials and Methods

Ticks infesting horses were collected using anatomical tweezers or a commercial hook and kept in ethanol-labeled tubes for taxonomic identification.

Results

A total of 2,238 ticks were found. Ticks were identified as 2,215 (98.89%, 95% CI: 98.41-99.28) Dermacentor nitens, 19 (0.98%, 95% CI: 0.05-1.38) Amblyomma sculptum, and 4 (0.18%; 95% CI: 0.007-0.46) Rhipicephalus microplus.

Conclusion

This is the first study to report A. sculptum and D. nitens in the State of Alagoas. The presence of A. sculptum should draw the attention of public health managers once Alagoas State is considered a silent area for rickettsial diseases, which means the absence of local surveillance programs for these pathogens.

Perception of Ticks and Tick-Borne Diseases Worldwide

In this comprehensive review study, we addressed the challenge posed by ticks and tick-borne diseases (TBDs) with growing incidence affecting human and animal health worldwide. Data and perspectives were collected from different countries and regions worldwide, including America, Europe, Africa, Asia, and Oceania. The results updated the current situation with ticks and TBD and how it is perceived by society with information bias and gaps. The study reinforces the importance of multidisciplinary and international collaborations to advance in the surveillance, communication and proposed future directions to address these challenges.

Diversity of rickettsiae in ticks (Acari: Ixodidae) collected from wild vertebrates in part of the Amazon, Cerrado, and Pantanal biomes in Brazil

Ticks parasitizing 102 wild animals in the states of Mato Grosso and Goiás, Brazil were collected between 2015 and 2018. A total of 2338 ticks (865 males, 541 females, 823 nymphs, and 109 larvae) belonging to four genera (Amblyomma, Dermacentor, Haemaphysalis, and Rhipicephalus) and at least 21 species were identified. DNA extraction and a molecular survey for rickettsial agents were performed on 650 ticks. The results revealed parasitism by the following species: Rickettsia amblyommatis in Amblyomma cajennense s.s., A. cajennense s.l., Amblyomma coelebs, Amblyomma humerale, Amblyomma longirostre, Amblyomma nodosum, Amblyomma scalpturatum, Amblyomma sculptum, and Amblyomma romitii; Rickettsia parkeri in Amblyomma nodosum, Amblyomma ovale, Amblyomma scalpturatum, and Amblyomma triste; Rickettsia rhipicephali in Haemaphysalis juxtakochi; Rickettsia sp. in A. cajennense s.s., A. nodosum, and A. sculptum, and lastly, 'Candidatus Rickettsia andeanae' in Amblyomma parvum and Rhipicephalus microplus. This study expands the body of knowledge about tick parasitism among wild animals, including new data concerning tick-host associations, and provides information about the epidemiology of tick-borne pathogens in the Center-West region of Brazil.

Evaluation of completeness and timeliness of data in the National Information System for Notifiable Diseases for spotted fever in the state of São Paulo, Brazil, 2007-2017

OBJECTIVE

to evaluate the completeness and timeliness of notifications of cases of spotted fever (SF) held on the Notifiable Health Conditions Information System (SINAN) in São Paulo State, Brazil, from 2007 to 2017.

METHODS

this was a descriptive and ecological study of confirmed human cases of SF regarding completeness and timeliness of ten fields of the notification form (good if ≥ 90% for most variables); time series analysis was performed using the Prais-Winsten technique.

RESULTS

we analyzed 736 records; among essential fields, only "Discharge date" showed poor completeness (68.5%). Timeliness was good for the "Investigation" and "Closure" fields; other time lapses were not adequate.

CONCLUSION

in São Paulo state, data completeness was good for most variables, whereas timeliness was not adequate (except for "Closure" and "Investigation"), pointing to the need for health education and communication actions about SF.

Neglected tropical diseases risk correlates with poverty and early ecosystem destruction

BACKGROUND

Neglected tropical diseases affect the most vulnerable populations and cause chronic and debilitating disorders. Socioeconomic vulnerability is a well-known and important determinant of neglected tropical diseases. For example, poverty and sanitation could influence parasite transmission. Nevertheless, the quantitative impact of socioeconomic conditions on disease transmission risk remains poorly explored.

METHODS

This study investigated the role of socioeconomic variables in the predictive capacity of risk models of neglected tropical zoonoses using a decade of epidemiological data (2007-2018) from Brazil. Vector-borne diseases investigated in this study included dengue, malaria, Chagas disease, leishmaniasis, and Brazilian spotted fever, while directly-transmitted zoonotic diseases included schistosomiasis, leptospirosis, and hantaviruses. Environmental and socioeconomic predictors were combined with infectious disease data to build environmental and socioenvironmental sets of ecological niche models and their performances were compared.

RESULTS

Socioeconomic variables were found to be as important as environmental variables in influencing the estimated likelihood of disease transmission across large spatial scales. The combination of socioeconomic and environmental variables improved overall model accuracy (or predictive power) by 10% on average (P < 0.01), reaching a maximum of 18% in the case of dengue fever. Gross domestic product was the most important socioeconomic variable (37% relative variable importance, all individual models exhibited P < 0.00), showing a decreasing relationship with disease indicating poverty as a major factor for disease transmission. Loss of natural vegetation cover between 2008 and 2018 was the most important environmental variable (42% relative variable importance, P < 0.05) among environmental models, exhibiting a decreasing relationship with disease probability, showing that these diseases are especially prevalent in areas where natural ecosystem destruction is on its initial stages and lower when ecosystem destruction is on more advanced stages.

CONCLUSIONS

Destruction of natural ecosystems coupled with low income explain macro-scale neglected tropical and zoonotic disease probability in Brazil. Addition of socioeconomic variables improves transmission risk forecasts on tandem with environmental variables. Our results highlight that to efficiently address neglected tropical diseases, public health strategies must target both reduction of poverty and cessation of destruction of natural forests and savannas.

The inoculation eschar of Rickettsia parkeri rickettsiosis in Brazil: Importance and cautions

Two well characterized tick-borne rickettsioses occur in Brazil. Rickettsia rickettsii caused spotted-fever, transmitted by Amblyomma sculptum and Amblyomma aureolatum, is a severe disease with a high case-fatality rate in the southeastern region of the country. Rickettsia parkeri strain Atlantic rainforest infections transmitted by adult Amblyomma ovale ticks cause a milder non-lethal febrile disease with an eschar (necrosis) at the tick bite site. Clinical diagnosis of rickettsiosis is challenging, particularly during the early stages of the illness when signs and symptoms are non-specific. Since eschar at the tick bite site has emerged as the main clinical feature of mild R. parkeri infections and used to differentiate it from severe R. rickettsii infection, its proper recognition, distinction from other tick bite lesions, and boundaries as a clinical tool must be highlighted. Of importance, eschars induced by Rickettsia must be differentiated from dermatoses caused by other tick-borne skin infections as well from lesions caused by the tick bite itself. We herein highlight information on eschar in rickettsial diseases in Brazil and discuss the need for further research on its clinical relevance and application in the diagnosis of spotted fever caused by R. parkeri strain Atlantic rainforest. In particular, we draw attention to diagnosis of other febrile diseases in the presence of concomitant tick bites.

Rickettsial infection in ticks from a natural area of Atlantic Forest biome in southern Brazil

From June 2013 to January 2014, blood sera samples and ticks were collected from domestic dogs and wild small mammals, and ticks from the vegetation in a preservation area of the Atlantic Forest biome (Turvo State Park), and the rural area surrounding the Park in Derrubadas municipality, state of Rio Grande do Sul, southern Brazil. Dogs were infested by Amblyomma ovale and Amblyomma aureolatum adult ticks, whereas small mammals were infested by immature stages of A. ovale, Amblyomma yucumense, Amblyomma brasiliense, Ixodes loricatus, and adults of I. loricatus. Ticks collected on vegetation were A. brasiliense, A. ovale, A. yucumense, Amblyomma incisum, and Haemaphysalis juxtakochi. Three Rickettsia species were molecularly detected in ticks: Rickettsia bellii in I. loricatus (also isolated through cell culture inoculation), Rickettsia amblyommatis in A. brasiliense, and Rickettsia rhipicephali in A. yucumense. The latter two are tick-rickettsia associations reported for the first time. Seroreactivity to Rickettsia antigens were detected in 33.5% (55/164) small mammals and 8.3% (3/36) canine sera. The present study reveals a richness of ticks and associated-rickettsiae in the largest Atlantic Forest Reserve of the state of Rio Grande do Sul, which is characterized by a rich fauna of wild mammals, typical of more preserved areas of this biome. Noteworthy, none of the detected Rickettsia species have been associated to human or animal diseases. This result contrasts to other areas of this biome in Brazil, which are endemic for tick-borne spotted fever caused by Rickettsia rickettsii or Rickettsia parkeri.

Antibody Prevalence and Risk Factors Associated with Rickettsia spp. in a Pediatric Cohort: SFGR Remains Underdiagnosed and Underreported in El Salvador

Spotted fever group rickettsioses (SFGR) are caused by a group of tick-borne pathogens that are increasing in incidence globally. These diseases are typically underreported and undiagnosed in low- and middle-income countries, and thus, have been classified as neglected bacterial pathogens. Countries with high poverty, low human development index score, and limited health infrastructure—like El Salvador in Central America—lack necessary surveillance for SFGR and other tick-borne pathogens. This paucity of baseline SFGR infection prevalence leaves vulnerable populations at risk of misdiagnosis. Further, tick-borne disease burdens in El Salvador are severely limited. To lay the foundation for tick-borne disease epidemiology in El Salvador, our team conducted two different enzyme-linked immunosorbent assays (ELISA) on banked human sera samples from a cohort of approximately 1000 pediatric participants from a high-risk vector-borne disease population. Eleven percent of all tested banked pediatric sera were positive for at least one ELISA assay at the time of enrollment: 10.7% were positive for only IgM antibodies (acute SFGR infection), and 2.5% were positive for IgG antibodies (a past SFGR infection). Older, male, children enrolled during the wet season, with a household history of infectious disease and higher maternal education level had higher odds of SFGR antibodies. Additionally, children from households with domestic poultry birds and previous knowledge of other vector-borne diseases had significantly reduced odds of SFGR antibodies. The large percentage of acute SFGR infections indicates that it continues to remain an underreported and undiagnosed issue in El Salvador and the Central American region. Much is still unknown regarding the complexity of the tick, animal host, and human host ecology transmission cycle of SFGR in El Salvador.

Capybara Ticks and the Urban Context of Spotted Fever in Brazil: An Overview

Spotted fever is caused by Rickettsia rickettsii and is transmitted through tick’s saliva. Humans, ticks, and capybaras (Hydrochoerus hydrochaeris) are often coexisting in environments that favor the spread of Brazilian spotted fever (BSF). Although capybaras do not transmit R. rickettsii, they can amplify these bacteria among tick vector populations, playing a significant role in the one health approach and epidemiology of the disease. Urban populations of capybaras have increased, especially in Southeast Brazil, as well as the number of cases and lethality of BSF have increased in the country since the 1980s. This expansion is mainly determined by the availability of food and the absence of predators. Thus, urban areas, including parks and university campuses, provide an abundance of food and protection against predators, ensuring the multiplication of the species and increasing the risk of transmission to humans due to the proximity of man with animals in the urban environment. Therefore, this chapter aims to address aspects of spotted fever, considering the many dimensions of the species involved, contributing to public strategies and policies.

Ixodid diversity and detection of spotted fever group Rickettsia spp. in ticks collected on birds in the Brazilian Atlantic Forest

The Brazilian Atlantic Forest helds one of the most diverse and unique avifauna in the world. Many vertebrate species are reservoirs of tick-borne pathogens, and birds are an important group among them due to their mobility which facilitates the dispersion of ticks and the infectious agents they carry. This study brings data on the tick diversity parasitizing birds and the molecular detection of Rickettsia spp. in these arthropods. Birds (n = 773) were captured, identified, and banded at Mata do Paraíso Research, Training, and Environmental Education Center located in Viçosa, Minas Gerais, Brazil. Birds were checked for the presence of ticks, which were individually collected, identified, and molecularly processed through Polymerase Chain Reaction (PCR) for the detection of Rickettsia spp. A total of 130 individuals were infested by ticks, and 479 tick specimens were collected, showing a seasonal distribution of the life stages throughout the year. Ticks were identified as Amblyomma longirostre (59/479); Amblyomma calcaratum (20/479); Amblyomma varium (3/479); Amblyomma sculptum (2/479) and Amblyomma spp. larvae (395/479). Seasonal distribution of the life stages of ticks was observed along the year and significant negative correlations were found between temperature and collected ticks and temperature and infested birds. From the evaluated samples of ticks, 25.44% (n= 43/169) scored positive for Rickettsia spp., and sequence analysis indicated high nucleotide identity with Rickettsia rhipicephali, R. massiliae, R. africae and R. honei marmionii. The potential for dispersal of ticks by birds added to the aggressiveness of species of the genus Amblyomma and the zoonotic potential of some species of Rickettsia are quite worrying when we consider that the study area is widely attended by students, researchers, people from the city and neighboring municipalities.

Soft and hard ticks (Parasitiformes: Ixodida) on humans: A review of Brazilian biomes and the impact of environmental change

Records of accidental parasitism by ticks in humans from Brazil are scarce, with most being reported by researchers who are parasitized during their research and by professionals who work with animals. In order to compile these records, an extensive literature review was carried out. Our revision includes studies published between 1909 and 2022, including nine species of the Argasidae family and 32 species of the Ixodidae family that were reported biting humans in the six biomes of the Brazilian territory. The species with the highest number of records of human parasitism was Amblyomma sculptum, followed by Amblyomma coelebs, Amblyomma cajennense sensu stricto, and Amblyomma brasiliense. The Atlantic Forest was the most frequent biome where human parasitism occurred, probably due to the greater number of inhabitants, universities, and researchers in the region; however, this does not mean that this biome is more conducive to the development of ticks and their parasitism in humans. In addition to Amblyomma ovale, a vector of Rickettsia parkeri in the country, two of the main species that act as vectors of Rickettsia rickettsii, A. sculptum, and Amblyomma aureolatum, have been reported, which is quite worrying considering that the wide distribution of the species and life stages most frequently mentioned in parasitism (i.e., nymphs and adults) are the ones that favour pathogen transmission. This research provides a significant contribution to the knowledge of tick species associated with human parasitism in Brazil; however, due to environmental change potentiated by deforestation and fires, it is expected that there will be a geographic expansion of some tick species and the pathogens that use them as a vector and an increase in human parasitism.

Mapping potential risks for the transmission of spotted fever rickettsiosis: The case study from the Rio de Janeiro state, Brazil

Spotted fever rickettsiosis is a zoonosis transmitted by ticks, having a varied clinical course that can lead to death if not managed properly. In Brazil it is more commonly observed in the Southeast, being an emerging public health problem. Hazard mapping models are common in different areas of knowledge, including public health, as a way of inferring reality and seeking to reduce or prevent damage. The aim of this study is to offer a spatial heuristic methodology for assessing the potential risk of transmission of spotted fever in the Rio de Janeiro state, located in the southeastern region of Brazil. For this, we used geospatial tools associated with eco-epidemiological data related to the clinical profile of the disease. The results achieved were substantially encouraging, considering that there are territories with greater or lesser expectation of risk for spotted fever in the study area. We observed that there are important distinctions between the two rickettsiosis scenarios in the same geographic space and that the areas where there is a greater potential risk of contracting rickettsiosis coincide with the administrative regions that concentrated the cases of hospitalization and deaths from the disease, concluding that the scenery found are relevant to the case series for the disease and that the planning of surveillance actions can gain in quality if the use of this spatial analysis tool is incorporated into the routine of local health management.

Diversity of tick species (Acari: Ixodidae) in military training areas in Southeastern Brazil

Tick-borne pathogens belong to one of the two main groups of occupational biohazards, and occupational exposure to such agents puts soldiers at risk of zoonotic infections, such as those caused by rickettsiae. There are few studies on acarological fauna and occupational risk in military areas in Brazil. Thus, the present study aimed to analyze the diversity of ticks present in the military training areas of municipalities in the Southeast Region of Brazil. The ticks were collected from the selected areas using the dragging and flagging techniques as well as by visual detection on the operators' clothing, and environmental information was also recorded. A total of ten species were collected from the 66 surveyed areas, belonging to five genera and nine species: Amblyomma sculptum, Amblyomma dubitatum, Amblyomma brasiliense, Amblyomma longirostre, Amblyomma aureolatum, Dermacentor nitens, Rhipicephalus spp., Ixodes spp. and Haemaphysalis spp. The frequent presence of tick species in military training areas along with traces and sightings of wild animals, most commonly capybaras (Hydrochoerus hydrochaeris), in most of the studied areas, indicates high levels of exposure of the military to tick vectors of spotted fever group rickettsiae and the possible occurrence of infections among the troops.

Comparing scapular morphology of Amblyomma sculptum and Amblyomma dubitatum nymphs allows a fast and practical differential diagnosis of ticks in highly infested areas with dominance of these two species

Rickettsia rickettsii infection causes the highest human fatality rate among all Rickettsia species of the world and is endemic in Southeast Brazil. In this part of the country most human spotted fever cases are related to unnaturally high populations of ticks, usually a mix of two species, Amblyomma dubitatum Neumann and Amblyomma sculptum Berlese and their local host, capybara (Hydrochoerus hydrochaeris). At the same time, an increase in the number of SF notifications as well as its urbanization was observed, and a better characterization of disease epidemiology is mandatory for control measures and to halt its expansion. It was recently noticed in southeast Brazil that SF endemic areas were characterized by overgrowth populations of A. sculptum and decreased populations of A. dubitatum. Hence, characterization of areas with potential to endemicity, eco-epidemiological studies and control measures may rely on the evaluation of A. sculptum/A. dubitatum rate. However, in potentially endemic scenarios, discriminating the two tick species, particularly the nymphs considered the main vector stage, is a challenge in face of several hundreds to thousands of ticks that should be examined for quantitative studies. We herein present additional morphological features to an existing identification key for Amblyomma nymphs that considerably diminishes the labor to distinguish nymphs of these two tick species. Specifically, the oval-shaped scutum of A. dubitatum and a conspicuous scapula of A. sculptum are prominent discriminating features.

Spotted Fever in the Morphoclimatic Domains of Minas Gerais State, Brazil

In Brazil, the tick-borne rickettsiosis known as Spotted Fever (SF) has been recorded from 59% of the Federative Units, however, the knowledge of the epidemiology and dynamics of human infection remains incipient in certain areas, complicating appropriate public health actions to inform the general population and control the disease. Here, we improved the interpretation of epidemiological information of SF cases recorded for an important endemic area. A descriptive epidemiological study was carried out based on records in the SINAN (Notifiable Diseases Information System) SF case databases. Data analysis was performed using Python programming language, Pandas library and Qgis map making. To evaluate the sociodemographic, clinical, assistance, laboratory and epidemiological characteristics, simple and relative nominal values of occurrences, means and standard deviations, and molecular analyzes were performed to identify the bioagent present in biological samples collected during each case investigation. Of the 298 confirmed cases, 98 resulted in death, the number of cases increased from 2011, and the disease scenario had 32.8% lethality. Overall, 207 cases involved men, and lethality was higher in this group. The most affected age group was 30 to 59 years old. The majority of patients reported having had contact with animals such as ticks, capybara and domestic animals such as dogs and cats. The results corroborate existing studies in areas of severe SF cases in Brazil. Despite reports of SF cases from the Cerrado Biome, analyses show that serious cases occur in anthropized areas of the Atlantic Forest biome, and in a transition area between this and the Cerrado. Complex, longitudinal, multidisciplinary studies, with an eco-epidemiological focus, should be carried out to allow the construction of algorithms capable of predicting, in time and space, the risk factors associated with severe cases and deaths from SF, with the aim of avoiding their expansion.

Clinical, epidemiological, and laboratory features of Rickettsia africae infection, African tick-bite fever: A systematic review

African tick-bite fever (ATBF), caused by Rickettsia africae, is the main tick-borne rickettsiosis and the second most frequent cause of fever after malaria in travelers returning from sub-Saharan Africa. General descriptions on ATBF were made in the first two decades after recognized as a new infectious entity, and since then, many authors have contributed to the knowledge of the disease by reporting clinical cases in scientific literature. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of confirmed R. africae rickettsiosis cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. A total of 48 scientific publications (108 confirmed cases) were analyzed in order to extract data for developing this review. Overall, our results show that R. africae rickettsiosis is more frequent in males in the age group of 18-64 years, more than 80% of the cases occurred in European travelers, South Africa was the country where most infections were acquired, and almost 40% of cases occurred in clusters. Clinically, more than 80% of the cases had fever and eschar (55% developed multiple eschars), rash was present in less than the half of cases, and lymphangitis was not a common sign (11%). Headache, myalgia and regional lymphadenopathy were predominant nonspecific clinical manifestation (mean of 60%, 49% and 51%, respectively). Our results show that at least 70% of R. africae cases had altered laboratory parameters, most often showing an increase in transaminases and C-reactive protein. Tetracycline-class antibiotics, as monotherapy, were used in most (>90%) of the patients. Overall, only 4% of cases had complications, 12% required hospitalization, and there was a 100% rate of clinical recovery.

Occurrence of tick-borne pathogens in dogs in a coastal region of the state of Ceará, northeastern Brazil

The aim of this study was to determine the occurrence of tick-borne pathogens (Ehrlichia canis, Babesia vogeli, Hepatozoon spp. and Rickettsia spp.) in dogs in Vila de Jericoacoara, coastal region of Ceará, Brazil. Blood samples were collected from 153 animals and analyzed using molecular and serological methods. Sixty animals were found to be infected or exposed to at least one of the pathogens studied. Babesia vogeli was the most prevalent pathogen (15%), followed by E. canis (13.7%) and Hepatozoon spp. (11.8%), which was identified as Hepatozoon canis through sequencing. Twenty dogs (13%) were seroreactive to Rickettsia spp. Rhipicephalus sanguineus sensu lato was observed on 11.8% of the animals. There were associations between age (< 3 years old) and positivity for B. vogeli, and between habitation (stray dogs) and positivity for H. canis. There were also associations between anemia and infection with H. canis, and between leukopenia and exposure to Rickettsia spp. No association was detected between clinical alterations and infection with or exposure to the pathogens studied. The results confirmed that pathogens of veterinary importance are circulating in northeastern Brazil and showed that dogs are exposed to Rickettsia species with zoonotic potential, thus indicating a need for vector control measures.

A new focus of spotted fever caused by Rickettsia parkeri in Brazil

Spotted fever (SF) is a tick-borne zoonosis caused by bacteria of the genus Rickettsia . The disease varies in severity from mild clinical forms to severe cases. In Brazil, Rickettsia rickettsii SF is the most serious rickettsiosis and can result in death if not diagnosed and treated at the onset of symptoms. The SF mild form is caused by Rickettsia parkeri strain Atlantic Rainforest, and this etiological agent has been reported in the South, Southeast and Northeast regions of the country, in areas of preserved or little antropized Atlantic Rainforest. Amblyomma ovale is the proven vector and dogs are the hosts associated with the bioagent cycle. During a SF case investigation in Paraty municipality, Rio de Janeiro State, an Atlantic Rainforest biome area in Southeastern Brazil, the human pathogen R. parkeri strain Atlantic Rainforest was detected by PCR in a sample of human skin inoculation eschar and in a female A. ovale tick collected from a dog. These results expand the known area of occurrence of this mild form rickettsiosis in Brazil. In addition, the results of the present study indicate the importance of implementing programs to control canine ectoparasites and to raise awareness of the risks of infection, signs and symptoms of SF caused by R. parkeri strain Atlantic Rainforest.

Risk factors associated with ticks and Rickettsia spp. exposure in wild boars (Sus scrofa), hunting dogs, and hunters of Brazil

Background and Aim:

Wild boars have recently been implicated as the maintainers and carriers of Amblyomma spp. ticks, which are essential for Rickettsia spp. transmission. Consequently, wild boar hunting may increase the risk of tick exposure and subsequent human tick-borne infection and disease. Therefore, this study was conducted to evaluate the risk factors for ticks and Rickettsia spp. exposure in wild boars, hunting dogs, and hunters in Brazilian biomes.

Materials and Methods:

The statistical relationship of Rickettsia spp. antibodies were evaluated using the Chi-square test in 80 wild boars, 170 hunting dogs, and 49 hunters.

Results:

The only statistically significant difference in seropositivity found in this study was between male and female wild boars (p=0.034), probably associated with in-park exposure to Amblyomma brasiliense infected with Rickettsia spp.

Conclusion:

The absence of statistical differences in the associated risk factors for hunting dogs and hunters may indicate a random exposure to Rickettsia spp.

Rickettsia parkeri strain Atlantic rainforest infecting Amblyomma ovale (Acari: Ixodidae) in the Amazon Biome (Acre state, Brazil)

There is a lack of studies regarding tick-associated Rickettsia in the Amazon biome. Aiming to contribute to this knowledge, our research group collected ticks in the Western Amazon to better understand the tick fauna and their associated Rickettsia. In this study, we detected Rickettsia parkeri strain Atlantic rainforest DNA in the tick Amblyomma ovale Koch, 1844 in Rio Branco municipality, Acre state, northern Brazil. This is the first time that the R. parkeri strain Atlantic rainforest has been reported in the Amazon biome and is the first evidence of the circulation of a pathogenic spotted fever group (SFG) Rickettsia in this biome. This finding provides substantial information to help public health authorities understand which species of Rickettsia may be related to Amazon spotted fever cases.

Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19

The Amazon biome is under severe threat due to increasing deforestation rates and loss of biodiversity and ecosystem services while sustaining a high burden of neglected tropical diseases. Approximately two thirds of this biome are located within Brazilian territory. There, socio-economic and environmental landscape transformations are linked to the regional agrarian economy dynamics, which has developed into six techno-productive trajectories (TTs). These TTs are the product of the historical interaction between Peasant and Farmer and Rancher practices, technologies and rationalities. This article investigates the distribution of the dominant Brazilian Amazon TTs and their association with environmental degradation and vulnerability to neglected tropical diseases. The goal is to provide a framework for the joint debate of the local economic, environmental and health dimensions. We calculated the dominant TT for each municipality in 2017. Peasant trajectories (TT1, TT2, and TT3) are dominant in ca. fifty percent of the Amazon territory, mostly concentrated in areas covered by continuous forest where malaria is an important morbidity and mortality cause. Cattle raising trajectories are associated with higher deforestation rates. Meanwhile, Farmer and Rancher economies are becoming dominant trajectories, comprising large scale cattle and grain production. These trajectories are associated with rapid biodiversity loss and a high prevalence of neglected tropical diseases, such as leishmaniasis, Aedes-borne diseases and Chagas disease. Overall, these results defy simplistic views that the dominant development trajectory for the Amazon will optimize economic, health and environmental indicators. This approach lays the groundwork for a more integrated narrative consistent with the economic history of the Brazilian Amazon.

Space use and activity of capybaras in an urban area

Due to the rapid growth of urban environments, interactions between animals and humans in cities are increasingly common. Large mammals, such as capybaras (Hydrochoerus hydrochaeris), provide benefits to people and biodiversity of urban areas, but can also result in conflicts, such as animal–vehicle collisions or disease transmission. As a consequence, understanding the space use of urban capybara, and the effect of human activity on capybaras, is conducive to the promotion of coexistence. We studied the home range and the role of human disturbance on activity and habitat selection of urban capybaras in the city of Campo Grande (Brazil). We monitored nine groups of capybaras living at four parks: two parks subjected to high human visitation on workdays and two on weekends. Home range of the urban capybaras in the study is larger than those reported in previous studies of wild capybaras. The capybaras under study presented a bimodal activity pattern, which was delayed on days of high human presence, increasing animals’ nocturnality. In addition, habitat selection was completely altered on days of high human presence, leading animals to increase avoidance of urban areas and reversing the selectivity patterns for forests, grasslands, and water bodies, that capybaras show on days with low human presence. Even when completely surrounded by an anthropic environment, our results indicate that a mosaic of grasslands near a water body and forested areas will allow capybaras to maintain daily activity and large home ranges. However, human presence significantly altered the daily activity patterns and habitat selection of capybara. Urban planners should account for these data to improve the coexistence of capybaras with humans and thereby minimize the potential for conflicts.

Seasonal dynamics and rickettsial infection in free-living Amblyomma dubitatum in the Atlantic forest biome in north-eastern Brazil

The genus Amblyomma is the most representative tick genus in Brazil and some species act as vectors of pathogenic organisms to animals and humans. Information on the seasonal dynamics of Amblyomma spp. as well as on rickettsial organisms infecting these ticks in some regions in Brazil is still fragmentary. Herein, we investigated the seasonal dynamics and rickettsial infections in Amblyomma dubitatum ticks collected in the Atlantic forest biome in north-eastern Brazil. Using carbon dioxide traps, ticks were collected monthly for two consecutive years. In total, 15,789 ticks were collected: 69 females (0.4%), 116 males (0.7%), 1,067 nymphs (6.8%), and 14,537 larvae (92.1%). All nymphs, females and males were identified as A. dubitatum, whereas larvae were identified as Amblyomma spp. Larvae were more frequent in summer (77% of the larvae collected), whereas nymphs were collected with similar frequency in summer (32.8%), autumn (30.0%) and spring (28.4%). Adults were more frequent in spring (47.6%). A total of 648 ticks (485 nymphs, 60 females, and 103 males) were tested by PCR for the gltA gene of Rickettsia spp. and 87 (13.4%; 95% CI: 10.9-16.3%) were positive. A consensus sequence (size, 350 bp) of 66 gltA gene sequences indicate that the organism detected herein is similar to Rickettsia tamurae, Rickettsia monacencis and Rickettsia sp. strain Pampulha. One of these positive samples was also positive for the ompA gene of spotted fever group rickettsiae, but attempts to sequence the amplicon were not successful. We also tested this sample by a PCR targeting the rickettsial htrA gene, but no amplification product could be detected. This study indicates that A. dubitatum may be a common tick in areas where capybaras are present in north-eastern Brazil, occurring during the whole year. It also suggests the circulation of a spotted fever group rickettsia in this A. dubitatum population, whose identity has yet to be determined.

Seasonal dynamics of Amblyomma sculptum in two areas of the Cerrado biome midwestern Brazil, where human cases of rickettsiosis have been reported

Amblyomma sculptum is a common human-biting tick in Brazil, where it plays an important role as a vector of Rickettsia rickettsii, the agent of the Brazilian spotted fever. Herein, we studied the seasonal dynamics of A. sculptum in an urban area of the Cerrado biome in midwestern Brazil, where human rickettsiosis is endemic. Ticks were collected in two sites located within the campus of Federal University of Goiás. The collections were done by dragging, flagging and visual search. In total, 117,685 ticks were collected, including 100,627 Amblyomma spp. larvae, 10,055 nymphs and 6977 adults of A. sculptum, and one nymph and 25 adults of Amblyomma dubitatum. The highest peak of larvae occurred in June 2018 and in July 2019, whereas nymphs peaked in July 2018 and September 2019. Adults reached their highest numbers in March 2018 and November 2019. These data suggest that A. sculptum develops one generation per year in this urban area of the Cerrado biome in midwestern Brazil. Interestingly, the peak of nymphs occurred during the same period of all confirmed cases of rickettsiosis in Goiás, suggesting a possible relationship between the seasonal dynamics of this tick stage and rickettsiosis transmission in this state.

Clinical, epidemiological, and laboratory features of Rickettsia parkeri rickettsiosis: A systematic review

Rickettsia parkeri rickettsiosis is recognized as the second most prevalent tick-borne disease caused by spotted fever group rickettsiae in the Americas, where two pathogenic strains (R. parkeri sensu stricto and R. parkeri strain Atlantic rainforest) have been related to human infections and transmitted by Amblyomma spp. ticks. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of R. parkeri rickettsiosis, including confirmed and probable cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. We excluded papers that contained missing information of some variables and publications in which it was not possible to separate data for confirmed and probable cases. A total of 77 clinical cases (32 confirmed cases and 45 probable cases) were considered for this review. Overall, our results show that R. parkeri rickettsiosis is more frequent in males in the age group of 18-64 years and that a history of tick exposure was frequent (>90%). Cases were described in the United States, Argentina, Brazil, Uruguay and Colombia. Clinically, more than 60% of the cases had fever (mean of 93%), eschar (mean of 87%), and rash (mean of 68%). Headache and myalgia were predominant nonspecific symptoms (mean of 67% and 61%, respectively). Our results show that at least 60% of R. parkeri cases had altered laboratory parameters, most often showing an increase in transaminases and leukopenia. Tetracyclines-class antibiotics were used in most (>85%) of the patients. Overall, only 9% of cases required hospitalization and there was a 100% rate of clinical recovery in all of cases.

Diversity of free-living ticks and serological evidence of spotted fever group Rickettsia and ticks associated to dogs, Porto Velho, Western Amazon, Brazil

Rondônia is the only state in the North Region of Brazil to have registered confirmed cases of Brazilian Spotted Fever (BSF). The present study investigated the epidemiological cycle of Rickettsia spp. by surveying free-living ixodofauna and tick parasitism of dogs in the municipality of Porto Velho, Rondônia State. Ticks and dogs were tested for the presence of Rickettsia spp. DNA and dog serum was tested for reactivity to anti-Rickettsia spp. antibodies. Tick collection and dog blood sampling were performed in peri-urban and rural environments at 11 locations. Eight free-living Amblyomma species and one Haemaphysalis species were collected: A. scalpturatum, A. naponense, A. oblongoguttatum, A. coelebs, A. latepunctatum, A. pacae, A. ovale, Amblyomma sp., and H. juxtakochi. Three tick species were found parasitizing dogs: Rhipicephalus sanguineus sensu lato, A. oblongoguttatum and A. ovale. Molecular analysis did not identify the presence of the gltA gene fragment in any tick specimen. Results from an indirect immunofluorescent assay (IFA) showed that 20.8% of peri-urban and 15.4% of rural dog sera exhibited reactivity to Rickettsia rhipicephali, Rickettsia amblyommatis, Rickettsia bellii and Rickettsia parkeri antigens. Antibody prevalence in dogs was 16.4%. This study is the first to describe the prevalence of Rickettsia spp. infection in dogs from Porto Velho municipality. Our findings enhance current knowledge of Rickettsia spp. circulation in the Western Amazon.

Needlestick-Associated Rocky Mountain Spotted Fever, Brazil

We report a fatal case of Rocky Mountain spotted fever (RMSF) in a man in Brazil without recent history of tick bites or environmental exposure. He received an accidental needlestick while working as a nurse. The nurse and his patient died. Both cases were confirmed as RMSF by molecular methods.

Isolate-Dependent Differences in Clinical, Pathological, and Transcriptional Profiles following In Vitro and In Vivo Infections with Rickettsia rickettsii

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 Smith^T, 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.

Biodiversity of Potential Vectors of Rickettsiae and Epidemiological Mosaic of Spotted Fever in the State of Paraná, Brazil

Spotted Fever Rickettsioses (SFR) are diseases caused by bacteria of the genus Rickettsia, and are transmitted mainly by ticks. Its eco-epidemiological scenarios vary spatially, and may also vary over time due to environmental changes. It is the main disease transmitted by ticks to humans in Brazil, with the state of Paraná (PR) having the sixth highest number of notified incidences in the country. However, information is lacking regarding the SFR disease cycles at likely infection sites within PR. During case investigations or environmental surveillance in PR for SFR, 28,517 arthropods were collected, including species known or potentially involved in the SFR cycles, such as Amblyomma sculptum, Amblyomma aureolatum, Amblyomma ovale, Amblyomma dubitatum, Amblyomma parkeri, Ctenocephalides felis felis, and Rhipicephalus sanguineus sensu lato. From these Rickettsia asembonensis, Rickettsia bellii, Rickettsia felis, Rickettsia parkeri strain Atlantic Rainforest and Candidatus Rickettsia paranaensis were detected. Ectoparasite abundance was found to be related with specific hosts and collection environments. Rickettsiae circulation was observed for 48 municipalities, encompassing 16 Health Regions (HR). As for socio-demographic and assistance indicators, circulation occurred largely in the most urbanized HR, with a higher per capita Gross Domestic Product, lower Family Health Strategy coverage, and with a higher ratio of beds in the Unified Health System per thousand inhabitants. For environmental variables, circulation occurred predominantly in HR with a climatic classified as “subtropical with hot summers” (Cfa), and with forest type phytogeographic formations. In terms of land use, circulation was commonest in areas with agriculture, pasture and fields and forest cover. Rickettsiae were circulating in almost all hydrographic basins of PR state. The results of this study provide the first descriptive recognition of SFR in PR, as well as outlining its eco-epidemiological dynamics. These proved to be quite heterogeneous, and analyzed scenarios showed characteristics strongly-associated with the outbreaks, with cases presenting clinical variation in space, so illustrating the complexity of scenarios in PR state. Due to the diversity of the circumstances surrounding SFR infections in PR, public health initiatives are necessary to foster a better understanding of the dynamics and factors effecting vulnerability to SFR in this Brazilian state.

The neglected challenge: Vaccination against rickettsiae

Over the last decades, rickettsioses are emerging worldwide. These diseases are caused by intracellular bacteria. Although rickettsioses can be treated with antibiotics, a vaccine against rickettsiae is highly desired for several reasons. Rickettsioses are highly prevalent, especially in poor countries, and there are indications of the development of antibiotic resistance. In addition, some rickettsiae can persist and cause recurrent disease. The development of a vaccine requires the understanding of the immune mechanisms that are involved in protection as well as in immunopathology. Knowledge about these immune responses is accumulating, and efforts have been undertaken to identify antigenic components of rickettsiae that may be useful as a vaccine. This review provides an overview on current knowledge of adaptive immunity against rickettsiae, which is essential for defense, rickettsial antigens that have been identified so far, and on vaccination strategies that have been used in animal models of rickettsial infections.

Rickettsial pathogens circulating in urban districts of Rio de Janeiro, without report of human Brazilian Spotted Fever

Spotted fever group rickettsioses are emerging diseases. In some of these diseases, domestic dogs act as sentinels. Canine serological studies have demonstrated that rickettsial dispersion is concentrated in rural areas, seroprevalence being higher where human rickettsioses are endemic. In Rio de Janeiro, the Atlantic forest vegetation has been devastated by urbanization. In this context, we aimed to detect Rickettsia spp. in urban areas of the West Zone of Rio de Janeiro. Sera from 130 dogs were tested by Indirect Immunofluorescence Assay, and ticks collected from these dogs were tested by polymerase chain reaction. We found the rate of serological reactions against R. rickettsii and R. parkeri in our study area to exceed those of rural and non-endemic areas, highlighting the importance of dogs as urban sentinels. The possibility of contact with opossums and capybaras increased the chances of exposure to Rickettsia spp., reinforcing the hypothetical link between the landscape and the rickettsial wild cycle. Rhipicephalus sanguineus sensu lato was the tick most frequently observed. PCR-positive samples showed similarity with R. rickettsii and R. felis, an emerging pathogen rarely reported from ticks. We observed that rickettsiae circulate in urban places and ticks from indoor environments, which may be involved in bacterial epidemiology.

Development and validation of an interactive educational technology on spotted fever

OBJECTIVE

to develop and validate an interactive educational technology on spotted fever, to offer an innovative teaching method.

METHOD

a methodological study that covered the following stages: analysis and diagnosis; instructional planning, didactic design, review, and validation and production of technology.

RESULTS

the analysis and diagnosis were obtained from experiences in education and health activities for spotted fever. In the instructional planning, it was defined that the technology would be presented in the form of an Interactive Laboratory, with learning stations. The production of the Laboratory was carried out by a multidisciplinary team made up of a carpenter, an electrician, and a plastic artist, among others. The review and validation process was subdivided into two stages: appearance and content validation by professionals in the fields of biology, and education and semantic validation by students of the Nursing and Pedagogy courses. The results of the appearance and content validation showed a content validity index over 0.8 for the vast majority of the variables. In the semantic validation, the Laboratory was evaluated positively by the students.

CONCLUSION

the trajectory followed for the construction of the Interactive Laboratory on spotted fever gave academic and scientific support to the product, offering an innovative educational resource with pedagogical potential that values significant learning.

Locomotion activity and its effects on the survival of Amblyomma sculptum (Acari: Ixodidae) nymphs under laboratory conditions

The active locomotion of ticks is directly associated with the epidemiology of tick-borne diseases, as it has important implications for the interaction of ticks with their hosts and their dispersion in the environment. In an attempt to elucidate the factors involved in the dispersion of Amblyomma sculptum, the present work aimed to characterize different aspects of the active locomotion of A. sculptum nymphs under laboratory conditions. To this end, nymphs were placed on a string at a 70° inclination and their walking activity was recorded daily along with their survival period. During their lifetime, ticks walked an average of 110 m. Their locomotion was not in a straight line and nymphs changed direction 142 times throughout their lifetimes. The mean distance walked per experimental day was 1.8 m, while the average walking distance before changing direction was 52 cm. The distance walked per experimental day reduced over time. The survival of ticks was affected by walking; resting nymphs survived for over 6 months, while the survival of those that walked daily was reduced to approximately 62 days. The results showed that A. sculptum nymphs were able to cover distances of over 100 m throughout their lifetimes, but they walked short distances at a time and constantly changed direction. This behavior indicates that ticks are not able to disperse over long distances by means of active locomotion.

Mapping Brazilian spotted fever: Linking etiological agent, vectors, and hosts

Brazilian spotted fever (BSF) is a highly lethal disease in southeastern Brazil. BSF is caused by the bacterium Rickettsia rickettsii and is transmitted by the bites of the tick of the genus Amblyomma. The spatial distribution of BSF risk areas is not well known in the country given the complexity of the transmission cycle. This study used the ecological niche modeling (ENM) approach to anticipate the potential distribution of the etiological agent (Rickettsia rickettsii), vectors (Amblyomma sculptum and A. dubitatum), and hosts (Hydrochoerus hydrochaeris, Didelphis aurita, and D. marsupialis) of BSF in Brazil. We compiled occurrence records for all vectors, hosts, and BSF from our own field surveillance, online repositories, and literature. ENM identified BSF risk areas in southeastern and southern Brazil, and anticipated other dispersed suitable areas in the western, central, and northeastern coast regions of Brazil. Tick vectors and mammalian hosts were confined to these same areas; however, host species showed broader suitability in northern Brazil. All species ENMs performed significantly better than random expectations. We also tested the BSF prediction based on 253 additional independent cases identified in our surveillance; the model anticipated 251 out of 253 of these independent cases. Background similarity tests comparing the ENMs of R. rickettsii, tick vectors, and mammalian hosts were unable to reject null hypotheses of niche similarity. Finally, we observed close coincidence between independent BSF cases, and areas suitable for combinations of vectors and hosts, reflecting the ability of these model pairs to anticipate the distribution of BSF cases across Brazil.

Risk Factors for Scrub Typhus, Murine Typhus, and Spotted Fever Seropositivity in Urban Areas, Rural Plains, and Peri-Forest Hill Villages in South India: A Cross-Sectional Study

Scrub typhus and spotted fever group rickettsioses are thought to be common causes of febrile illness in India, whereas they rarely test for murine typhus. This cross-sectional study explored the risk factors associated with scrub typhus, tick-borne spotted fever, and murine typhus seropositivity in three different geographical settings, urban, rural, and hill villages in Tamil Nadu, South India. We enrolled 1,353 participants living in 48 clusters. The study included a questionnaire survey and blood sampling. Blood was tested for Orientia tsutsugamushi (scrub typhus), Rickettsia typhi (murine typhus), and spotted fever group Rickettsia IgG using ELISA. The seroprevalence of scrub typhus, spotted fever, and murine typhus were 20.4%, 10.4%, and 5.4%, respectively. Scrub typhus had the highest prevalence in rural areas (28.1%), and spotted fever was most common in peri-forested areas (14.9%). Murine typhus was more common in rural (8.7%) than urban areas (5.4%) and absent in peri-forested hill areas. Agricultural workers had a higher relative risk for scrub typhus, especially in urban areas. For murine typhus, proximity to a waterbody and owning a dog were found to be major risk factors. The main risk factors for spotted fever were agricultural work and living in proximity to a forest. Urban, rural plains, and hill settings display distinct epidemiological pattern of Orientia and rickettsial infections. Although scrub typhus and spotted fever were associated with known risk factors in this study, the findings suggest a different ecology of murine typhus transmission compared with other studies conducted in Asia.

Capybaras (Hydrochoerus hydrochaeris) as amplifying hosts of Rickettsia rickettsii to Amblyomma sculptum ticks: Evaluation during primary and subsequent exposures to R. rickettsii infection

Rickettsia rickettsii is the agent of Brazilian spotted fever (BSF), the most lethal tick-borne disease in the western hemisphere. Amblyomma sculptum is the main vector of R. rickettsii in southeastern Brazil. Capybaras act as primary hosts for this tick species, and as amplifying hosts for R. rickettsii, creating new infected lineages of A. sculptum in BSF-endemic areas. In a recent study, we demonstrated that capybaras successively exposed to R. rickettsii-infected A. sculptum ticks developed a mean rickettsemic period of 9.2 days during primary infection, but no rickettsemia during subsequent expositions, when capybaras were immune to R. rickettsii. During the primary and subsequent infections, capybaras were also infested with uninfected A. sculptum ticks. These infestations compose the present study, which aimed to evaluate: (i) if either rickettsemic or non-rickettsemic capybaras could serve as infection sources of R. rickettsii for A. sculptum larvae and nymphs; (ii) the vector competence of the subsequent nymphs and adults (molted from the engorged ticks collected from capybaras); and (iii) if there were R. rickettsii-acquisition by uninfected ticks co-feeding with infected ticks on immune capybaras (without rickettsemia). Through experimental infection of capybaras with R. rickettsii via tick feeding, simulating a natural condition, we demonstrated that primarily infected capybaras developed rickettsemia that resulted in successful acquisition feeding of larvae and nymphs of A. sculptum, since part of these ticks maintained R. rickettsii transstadially, and the resultant molted ticks (either nymphs or adults) successfully transmitted the bacterium by feeding on susceptible rabbits. Contrastingly, all rabbit infestations with ticks derived from acquisition feeding on R. rickettsii-immune capybaras (including when acquisition ticks fed in direct contact with donor ticks) evidenced absence of R. rickettsii transmission due to lack of clinical signs and antibody response in those rabbits. Our results indicate that capybaras could serve as R. rickettsii-amplifying hosts for A. sculptum ticks only during the capybara's primary infection, but not during subsequent infections on immune capybaras. Finally, the probable co-feeding nonsystemic transmission of R. rickettsii seems to be irrelevant in the context of BSF epidemiology, in areas where capybaras are incriminated as main amplifying hosts of R. rickettsii for A. sculptum ticks.

Human Parasitism by Amblyomma parkeri Ticks Infected with Candidatus Rickettsia paranaensis, Brazil

Spotted fever is the main rickettsial disease in Brazil. We report 12 cases of human parasitism by Amblyomma parkeri in the Atlantic rainforest, an area of Brazil to which spotted fever is endemic. Nine of the ticks were infected with Candidatus Rickettsia paranaensis.

Spotted fever group rickettsial infection in dogs and their ticks from domestic-wildlife interface areas in southeastern Brazil

Rickettsia rickettsii is the causative agent of Brazilian spotted fever (BSF), for which humans and dogs are both susceptible. Dogs are sentinels in serological surveys, however, canine disease is rarely reported. Therefore, we aimed to evaluate natural infection by spotted fever group (SFG) Rickettsia spp. in dogs and ticks collected from domiciles close to forest fragments, featuring domestic-wildlife interface areas. Samples from 115 dogs and 135 ixodids were assessed by polymerase chain reactions (PCR) targeting the gltA gene for Rickettsia spp. and the ompA gene for the SFG rickettsial species. One dog (0.87%; 1/115) was positive for R. rickettsii. This dog presented nonspecific laboratory and clinical abnormalities (thrombocytopenia, hyperproteinemia, lymph node enlargement, emaciation, anorexia, and lethargy). Rickettsia parkeri was identified in 2.96% (4/135) of the ticks (Amblyomma sculptum, A. aureolatum, and Rhipicephalus sanguineus). This study confirmed the presence of SFG bacteria in non-endemic and preserved locations, where domestic and wild populations interact. We reinforce the fact that the dog is susceptible to natural R. rickettsii infection. Although this is a rare finding, preventive measures should be taken against BSF in the studied areas. Finally, R. parkeri infection is possibly being demonstrated in A. sculptum for the first time.