Prevalence Data of Rickettsia slovaca and Other SFG Rickettsiae Species in Dermacentor marginatus in the Southeastern Iberian Peninsula

First report of the molecular detection of human pathogen Rickettsia raoultii in ticks from the Republic of Korea

Background

Rickettsial diseases associated with the spotted fever group constitute a growing number of newly identified Rickettsia pathogens and their tick vectors in various parts of the world. At least 15 distinct tick species belonging to six genera have shown the presence of Rickettsia raoultii. Herein, we report the detection of R. raoultii in ticks from the Republic of Korea (ROK).

Methods

Thirty-five ticks were collected from 29 patients with tick bites in Gwangju Metropolitan City, Jeollanam Province, ROK. The ticks were identified using molecular, morphological, and taxonomic characteristics. All samples were screened for presence of Rickettsia species using nested polymerase chain reactions of their outer membrane protein (ompA) and citrate synthase (gltA) genes. The amplified products were sequenced for subsequent phylogenetic analyses.

Results

Sequencing data showed the DNA sequences of R. raoultii in three Haemaphysalis longicornis ticks. All three tick samples were 99.4–100% similar to previously reported partial sequences of ompA of R. raoultii strains CP019435 and MF002523, which formed a single clade with the reference strains.

Conclusions

We provide the first description and molecular identification of R. raoultii detected in H. longicornis ticks in the ROK. This observation extends the geographical distribution of R. raoultii. Screening of human samples for this pathogen will provide information about the prevalence of rickettsial infections in this region.

The Unexpected Holiday Souvenir: The Public Health Risk to UK Travellers from Ticks Acquired Overseas

Overseas travel to regions where ticks are found can increase travellers' exposure to ticks and pathogens that may be unfamiliar to medical professionals in their home countries. Previous studies have detailed non-native tick species removed from recently returned travellers, occasionally leading to travel-associated human cases of exotic tick-borne disease. There are 20 species of tick endemic to the UK, yet UK travellers can be exposed to many other non-native species whilst overseas. Here, we report ticks received by Public Health England's Tick Surveillance Scheme from humans with recent travel history between January 2006 and December 2018. Altogether, 16 tick species were received from people who had recently travelled overseas. Confirmed imports (acquired outside of the UK) were received from people who recently travelled to 22 countries. Possible imports (acquired abroad or within the UK) were received from people who had recently travelled to eight European countries. Species-specific literature reviews highlighted nine of the sixteen tick species are known to vector at least one tick-borne pathogen to humans in the country of acquisition, suggesting travellers exposed to ticks may be at risk of being bitten by a species that is a known vector, with implications for novel tick-borne disease transmission to travellers.

Isolation and Identification of Rickettsia raoultii in Human Cases: A Surveillance Study in 3 Medical Centers in China

Background

Rickettsia raoultii is frequently detected in multiple tick species, whereas human infection remains scarcely studied.

Methods

A surveillance study was performed at 3 sentinel hospitals in China, to recruit participants with suspected tick exposure. Rickettsia raoultii infection was identified through polymerase chain reaction, followed by sequencing, and confirmed serologically. Isolation by cell culture was performed and the isolates were genome sequenced.

Results

Twenty-six subjects were determined to have R. raoultii infection, including 7 with asymptomatic infection, 15 with mild to moderate illness, and 4 with severe illness. Common nonspecific manifestations in the 19 patients with mild to moderate or severe illness included fever (100%), malaise (95%), myalgia (58%), lymphadenopathy (53%), and nausea (42%). Only 5% of them had rash, and 16% had eschar. Scalp eschar and neck lymphadenopathy after a tick bite syndrome was only seen in 2 patients. Of the 4 patients with severe complications, 3 developed pulmonary edema, and 1 developed clouding of consciousness and lethargy. Frequent abnormalities of laboratory testing included leukopenia, thrombocytopenia, lymphopenia, neutropenia, hypoproteinemia, and elevated levels of total bilirubin, hepatic aminotransferases, lactate dehydrogenase, and creatine kinase. All the 19 patients recovered without sequelae after receiving doxycycline treatment. Two R. raoultii strains were isolated, and a significantly less degraded genome was observed than other more virulent Rickettsia strains, indicating a low pathogenicity of the current strain.

Conclusions

Human infection with R. raoultii has a wide clinical spectrum that ranged from subclinical infection to severe complications. Physicians need to be aware of the high potential and clinical complexity of R. raoultii infection, to ensure appropriate testing and treatment in endemic regions.

A case with neurological abnormalities caused by Rickettsia raoultii in northwestern China

Background

The number of new rickettsial species are rapidly increasing, and increasing numbers of Rickettsia raoultii (R. raoultii) infection cases have been detected in humans. However, neurological abnormalities caused by R. raoultii are rarely reported, especially in northwestern China.

Case presentation

A 36-year-old Kazakh shepherd with an attached tick on part temporalis, presented with right eyelid droop, lethargy, fever, headache, fever (38.0–41.0 °C) and erythematous rash. The examination of cerebrospinal fluid (CSF) showed cerebrospinal pressure of 200 mm H₂O, leukocyte count of 300.0 × 10⁶/L, adenosine deaminase of 2.15 U/L, and total protein concentration of 0.93 g/L. The diagnosis of R. raoultii infection was confirmed by six genetic markers, and semi-quantified by enzyme-linked immunosorbent assay for rickettsial antigen. The patient gradually recovered after treatment with doxycycline and ceftriaxone. R. raoultii DNA was found both in a tick detached from this patient and in 0.18% (2/1107) of blood samples collected from local shepherds.

Conclusions

This is the first reported case with neurological abnormalities caused by R. raoultii in northwestern China. It is vital to detect rickettsial agents both in blood and CSF for tick bite patients with neurological abnormalities. Public health workers and physicians should pay attention to neurological abnormalities caused by Rickettsia.

Comparative proteomics of the vector Dermacentor reticulatus revealed differentially regulated proteins associated with pathogen transmission in response to laboratory infection with Rickettsia slovaca

BACKGROUND

Tick-borne rickettsial diseases are caused by pathogens acquired from hard ticks. In particular, Rickettsia slovaca, a zoonotic infectious bacterium causing tick-borne lymphadenopathy (TIBOLA), is transmitted by the vectors Dermacentor spp. that can be found all over Europe. Although recent studies point out the extreme complexity of bacteria-induced effects in these blood-feeding vectors, the knowledge of individual molecules involved in the preservation and transmission of the pathogen is still limited. System biology tools, including proteomics, may contribute greatly to the understanding of pathogen-tick-host interactions.

METHODS

Herein, we performed a comparative proteomics study of the tick vector Dermacentor reticulatus that was experimentally infected with the endosymbiotic bacterium R. slovaca. Rickettsia-free ticks, collected in the southern region of Slovakia, were infected with the bacterium by a capillary tube-feeding system, and the dynamics of infection was assessed by quantitative PCR method after 5, 10, 15 and 27 days.

RESULTS

At the stage of controlled proliferation (at 27 dpi), 33 (from 481 profiled) differentially abundant protein spots were detected on a two-dimensional gel. From the aforementioned protein spots, 21 were successfully identified by tandem mass spectrometry.

CONCLUSIONS

Although a few discovered proteins were described as having structural or housekeeping functions, the vast majority of the affected proteins were suggested to be essential for tick attachment and feeding on the host, host immune system evasion and defensive response modulation to ensure successful pathogen transmission.

Isolation of known and potentially pathogenic tick-borne microorganisms from European ixodid ticks using tick cell lines

Ticks harbour and, in many cases transmit to their vertebrate hosts, a wide variety of pathogenic, apathogenic and endosymbiotic microorganisms. Recent molecular analyses have greatly increased the range of bacterial species potentially associated with ticks, but in most cases cannot distinguish between surface contaminants, microorganisms present in the remains of the previous blood meal and truly intracellular or tissue-associated bacteria. Here we demonstrate how tick cell lines, primary cell cultures and organ cultures can be used to isolate and propagate bacteria from within embryonic and adult Ixodes ricinus, Dermacentor marginatus and Dermacentor reticulatus ticks originating from different parts of Europe. We isolated and partially characterised four new strains of Spiroplasma from The Netherlands, Spain and Poland, two new strains of Rickettsia raoultii from Russia and Poland, one strain of Rickettsia slovaca from Spain and a species of Mycobacterium from the UK. Comparison with published sequences showed that the Spiroplasma strains were closely related to Spiroplasma ixodetis and the Mycobacterium isolate belonged to the Mycobacterium chelonae complex, while the R. raoultii and R. slovaca strains were similar to previously-validated species.

Low-cost light-induced therapy to treat rickettsial infection

Antimicrobial photodynamic therapy uses a nontoxic photosensitizer with the assistance of harmless visible light to activate the photosensitizer. Consequently, the excited state of the photosensitizer interacts with molecular oxygen to produce reactive oxygen species, which have the antimicrobial effect. In this study, we evaluated the effect of photodynamic therapy on Vero cells infected with rickettsia using methylene blue as a photosensitizer along with red light. A significant reduction (by 96%) in the number of viable Rickettsia slovaca was determined by quantitative RT-PCR 48 h after the treatment with methylene blue followed by 30 min of red light excitation. A statistically significant reduction of R. slovaca was also recorded with pretreatment (by 99%). To the best of our knowledge, this result is the first one in the literature to confirm the effectiveness of photodynamic therapy for the elimination of R. slovaca and to suggest this technique as a good supportive treatment for rickettsial infections.

Neglected aspects of tick-borne rickettsioses

Rickettsioses are among the oldest known infectious diseases. In spite of this, and of the extensive research carried out, many aspects of the biology and epidemiology of tick-borne rickettsiae are far from being completely understood. Their association with arthropod vectors, the importance of vertebrates as reservoirs, the rarity of clinical signs in animals, or the interactions of pathogenic species with rickettsial endosymbionts and with the host intracellular environment, are only some examples. Moreover, new rickettsiae are continuously being discovered. In this review, we focus on the ‘neglected’ aspects of tick-borne rickettsioses and on the gaps in knowledge, which could help to explain why these infections are still emerging and re-emerging threats worldwide.

First Report of Rickettsia Identical to R. slovaca in Colony-Originated D. variabilis in the United States: Detection, Laboratory Animal Model, and Vector Competence of Ticks

Ticks of the genus Dermacentor are known vectors of rickettsial pathogens in both the Old World and New World. In North America, Dermacentor variabilis and D. andersoni are vectors of Rickettsia rickettsii, while in Europe, D. marginatus and D. reticulatus transmit R. slovaca and R. raoultii, respectively. Neither the presence of R. slovaca in the Americas nor the ability of American tick species to maintain this pathogen have been reported. Here we describe detection of Rickettsia genetically identical to R. slovaca in D. variabilis, its molecular characterization, assessment of pathogenicity to guinea pigs, and vector competence of D. variabilis ticks. Ticks from a laboratory colony of D. variabilis, established from wild ticks and maintained on naïve NZW rabbits, tested positive for spotted fever group (SFG) Rickettsia by PCR. Analysis of 17 kDa gltA, rpoB, ompA, ompB, and sca4 genes revealed 100% identity to R. slovaca sequences available in the GenBank. New Zealand white rabbits fed upon by infected ticks seroconverted to SFG Rickettsia. Guinea pigs inoculated with the Rickettsia culture or infested by the infected ticks developed antibodies to SFG Rickettsia. The intensity of clinical signs and immune response were dependent on dose and route of infection. The identified Rickettsia was detected in all life stages of D. variabilis ticks, confirming transstadial and transovarial transmission. Thirty-six percent of uninfected larvae co-fed with infected nymphs on guinea pigs were PCR-positive and able to pass rickettsia to at least 11.7% of molted nymphs. To our knowledge, this is a first report of identification of a European pathogen R. slovaca or a highly similar agent in the American dog tick, D. variabilis. Considering pathogenicity of R. slovaca in humans, further laboratory and field studies are warranted to assess the relevance of the above findings to the public health and epidemiology of SFG rickettsioses in the United States.

Isolation of a Rickettsia slovaca-Like Agent from Dermacentor variabilis Ticks in Vero Cell Culture

Rickettsia slovaca is transmitted by Dermacentor marginatus ticks, and is the causative agent of tick-borne lymphadenopathy and Dermacentor-borne necrosis erythema lymphadenopathy throughout Europe. It has not been found in New World ticks, nor have tick-borne lymphadenopathy or Dermacentor-borne necrosis erythema lymphadenopathy been reported in humans in the Americas. Here we describe the isolation of a R. slovaca-like agent from D. variabilis nymphs from a colony of ticks derived from field collected adults.

Co-circulation of multiple species of Rickettsiales bacteria in one single species of hard ticks in Shenyang, China

Bacteria in the order Rickettsiales include some of the most important zoonotic (re)emerging pathogens for animals and humans. In 2012, a total of 1267 adult Haemaphysalis longicornis ticks were collected from domestic animals (cattle and sheep) in Shenyang of Liaoning Province, China. These ticks were grouped into 181 pools (each pool with 6-7 ticks). Rickettsiales agents were identified in 93 (51.38%) tick pools using PCR targeting rrs (16S rRNA). In addition to 16S rRNA gene sequences, gltA and groEL gene sequences were also recovered from these positive samples. Phylogenetic analyses of these sequences revealed the presence of five species of Rickettsiales bacteria in a single tick species (H. longicornis) in nature in Shenyang, including Rickettsia japonica, Rickettsia raoultii, Anaplasma centrale, Anaplasma bovis, and a potentially novel A. phagocytophilum variant. Additionally, two Candidatus Ehrlichia spp. (Ehrlichia sp. Yonaguni138, Candidatus Ehrlichia shimanensis) were also identified in these ticks, with the highest prevalence of Ehrlichia sp. Yonaguni138 (73/181, 40.3%). Notably, these agents except the novel A. phagocytophilum variant had close evolutionary relationships with those previously identified in northeastern Asian countries including Korea, Japan, and Russia, indicating a geographic clustering pattern. Our data also reinforce the need for vigilance in recognition and prevention of rickettsiosis, ehrlichiosis, and anaplasmosis in humans and animals in this region.

[Update on SENLAT syndrome: scalp eschar and neck lymph adenopathy after a tick bite]

SENLAT syndrome, also known as TIBOLA/DEBONEL, is an emerging disease in France. The major symptoms are necrotic eschar on the scalp associated with painful cervical lymphadenopathy. It occurs mainly in women and children during the cold seasons after a bite by a Dermacentor tick, responsible for transmitting Rickettsia slovaca or Rickettsia raoultii. Cutaneous swabs are safe, easy and reliable tools that should be used routinely by physicians to confirm diagnosis. In this particular disease, they should be preferred to serology, which is less sensitive. Doxycycline is the antibiotic of choice for this syndrome.

Prevalence and burden of two rickettsial phylotypes (G021 and G022) in Ixodes pacificus from California by real-time quantitative PCR

The western black-legged tick, Ixodes pacificus Cooley and Kohls, commonly bites humans in the far western U.S. In addition to transmitting Lyme borreliosis and anaplasmosis, it is a host of nonpathogenic bacteria as well as some of unknown pathogenicity. In this study, we report the detection, prevalence, and burden of 2 rickettsial phylotypes with unknown pathogenicity in I. pacificus ticks from 6 California counties using real-time quantitative PCR with phylotype-specific primers and probes. Prevalence of rickettsial phylotypes G021 and G022 from 247 I. pacificus ticks was 100% and 2.0%, respectively. The median burden of phylotype G021 was 7.3 per tick cell, whereas the burden of phylotype G022 was 0.8 per tick cell. The burden of phylotype G021 significantly differed between collection sites and between vegetation habitats. Ticks collected from the coastal sage scrub habitat of southern California had a lower burden of phylotype G021 when compared to central California oak woodland, northern California oak woodland, and mixed evergreen and ponderosa pine-oak habitats of northern California. No significant correlation was found between the burden of the phylotype G021 in the presence and absence of the phylotype G022 in I. pacificus, suggesting that the presence of these Rickettsia species do not interfere with each other in I. pacificus.

Tick-borne rickettsioses in Europe

Rickettsioses are caused by obligate intracellular bacteria within the genus Rickettsia, mainly transmitted by arthropods. Until recently, Mediterranean spotted fever (MSF) caused by Rickettsia conorii was considered the only tick-borne rickettsiosis in Europe. However, 'new' TBR have been described in Europe during last years. For instance, other subspecies such as R. conorii caspia and R. conorii israelensis have been involved in MSF. Dermacentor-borne necrosis erythema and lymphadenopathy/tick-borne lymphadenopathy (DEBONEL/TIBOLA) cases caused by Rickettsia slovaca, Rickettsia raoultii, and Rickettsia rioja been described in several countries where Dermacentor marginatus ticks (the mainly implicated vector) are present. Rickettsia helvetica has also been involved as a human pathogen in cases of fever with and without rash and in patients with meningitis and carditis. Other TBR such as lymphangitis-associated rickettsioses (LAR), caused by Rickettsia sibirica mongolitimonae, have been diagnosed in different European countries (France, Spain, Portugal and Greece). Rickettsia massiliae is considered an etiological agent of MSF-like illness in the Mediterranean basin. Furthermore, Rickettsia monacensis that is distributed all along Europe has been isolated from patients with MSF-like illness in Spain. Although Rickettsia aeschlimannii has been associated with MSF-like in Africa and is distributed in the Mediterranean area, no autochthonous human cases have been reported for Europe. Other Rickettsia species detected in ticks and unrelated to human disease (Candidatus Rickettsia kotlanii, Candidatus Rickettsia barbariae, Candidatus Rickettsia vini) could be potentially involved in the next years. Climate changes, among other factors, may contribute to the emergence of other rickettsioses or change their distribution. Lastly, African tick-bite fever (ATBF), caused by Rickettsia africae, is frequently diagnosed in Europe in patients returning from endemic areas.

Rickettsia slovaca and Rickettsia raoultii in Dermacentor marginatus and Dermacentor reticulatus ticks from Slovak Republic

Rickettsiae, obligate intracellular Gram-negative bacteria, responsible for mild to severe diseases in humans are associated with arthropod vectors. Dermacentor marginatus and Dermacentor reticulatus are known vectors of Rickettsia slovaca and Rickettsia raoultii distributed across Europe. A total of 794 D. marginatus, D. reticulatus and Ixodes ricinus adult ticks were collected from the vegetation, removed from horses, sheep, goats and dogs in Slovakia. The DNA of Rickettsia sp. was found in 229 ticks by PCR amplifying parts of gltA, ompA and sca4 genes. Next analyses of Rickettsia-positive samples by PCR-RFLP and/or sequencing showed D. reticulatus ticks were more infected with R. raoultii and D. marginatus were more infected with R. slovaca. The prevalence of R. raoultii was 8.1-8.6% and 22.3-27% in D. marginatus and D. reticulatus, respectively. The prevalence of R. slovaca was 20.6-24.3% in D. marginatus and 1.7-3.4% in D. reticulatus. Intracellular growth of R. raoultii isolate from D. marginatus tick was evaluated by rOmpA-based quantitative SybrGreen PCR assay. The highest point of multiplication was recorded on the 7th and 8th day postinfection in Vero and L929 cells, respectively. R. raoultii was transmitted during feeding of R. raoultii-positive ticks to guinea pigs and subsequently rickettsial infection was recorded in all organs, the highest infection was in spleen, liver and heart. Our study describes the detection and isolation of tick-borne pathogens R. raoultii and R. slovaca, show that they are spread in Slovakia and highlight their risk for humans.

First detection of spotted fever group rickettsiae inIxodes ricinusandDermacentor reticulatusticks in the UK

A preliminary study was conducted to determine the presence of spotted fever rickettsiae in two species of British tick (Ixodes ricinusandDermacentor reticulatus). The 16S rRNA gene ofRickettsiaspp. was detected in 39/401 (9·7%) of ticks tested, including 22/338 (6·5%)I. ricinusand 17/63 (27%)D. reticulatus. Some positiveI. ricinussamples showed 100% homology withRickettsia helvetica(10/22), and most positiveD. reticulatusshowed 100% homology withR. raoultii(13/17). Five otherRickettsiaspp. were detected exhibiting 96–99% homology. Ticks positive for rickettsiae were collected from various hosts and from vegetation from eight counties across Great Britain. The distribution ofR. helveticain various engorged and unfed stages ofI. ricinussuggests thatR. helveticais widespread.R. raoultiiwas found in questing adultD. reticulatusin Wales and England. This is the first evidence of potentially pathogenic spotted fever rickettsiae in British ticks.

Rickettsia slovaca and R. raoultii in tick-borne Rickettsioses

Tick-borne lymphadenopathy (TIBOLA), also called Dermacentor-borne necrosis erythema and lymphadenopathy (DEBONEL), is defined as the association of a tick bite, an inoculation eschar on the scalp, and cervical adenopathies. We identified the etiologic agent for 65% of 86 patients with TIBOLA/DEBONEL as either Rickettsia slovaca (49/86, 57%) or R. raoultii (7/86, 8%).

Prevalence of tick-borne zoonotic bacteria in questing adult ticks from northern Spain

A total of 691 questing adult ixodid ticks of the genera Ixodes, Haemaphysalis, Dermacentor, and Rhipicephalus were tested by polymerase chain reaction (PCR) and reverse line blot (RLB) for the presence of Anaplasma phagocytophilum, Coxiella burnetii, Borrelia spp., and spotted fever group (SFG) rickettsiae. Ticks were collected by blanket dragging during 2 sampling years (2003-2005) in 10 recreational areas in the Basque Country (Northern Spain). Adult ticks were collected every month of the year and eight different species were identified among which Ixodes ricinus was the most abundant and widespread. Three pathogens for humans, Borrelia burgdorferi, A. phagocytophilum, and C. burnetii, as well as rickettsiae of unknown pathogenicity were detected. The latter were identified as Rickettsia sp. RpA4/DnS14 by sequencing of the citrate synthase (gltA) gene. The infection rates varied from 0.1%-6.9%. DNA of A. phagocytophilum was detected mainly in I. ricinus, but also in Haemaphysalis punctata, H. concinna, and Rhipicephalus bursa. Coxiella burnetii was detected in only one specimen of H. punctata, and Borrelia spp. in eight ticks. Furthermore, PCR-RLB analysis specific for B. burgdorferi sensu lato detected one H. punctata with positive hybridization with the B. burgdorferi sensu stricto probe, and two I. ricinus positive for B. afzelii and B. garinii. SFG rickettsiae were the pathogens most frequently found, present in 48 of 97 D. reticulatus analyzed. Mixed infections were not found in any of the analyzed ticks. These results are compared and discussed with data obtained in previous studies carried out in the same and other regions.

Rickettsia slovaca infection in humans in the northeast of Spain: seroprevalence study

Catalonia is an endemic area of Mediterranean spotted fever. In 1997, A. Lakos described a new tick-borne infectious disease called tick-borne lymphadenopathy. The causative agent is Rickettsia slovaca, which is transmitted by Dermacentor marginatus ticks. We have diagnosed human cases in Catalonia. The objective of this study was to determinate seroprevalence of R. slovaca infection in humans in the northeast of Spain. The population included 217 subjects from Catalonia, northeast of Spain and was stratified by age and living place (rural, suburban, and urban). Age, gender, residence area, contact with animals, occupation, and history of rickettsioses was surveyed. Immunoglobulin G was measured by indirect immunofluorescence assay. Titers >or= 1/40 were considered. Seroprevalence of R. slovaca was 5.5% at titers of 1/40-1/320. Eight (3.7%) sera had antibodies against R. slovaca exclusively. Four sera reacted also against Rickettsia conorii and/or Bar29. Seroprevalence of R. slovaca would range from 3.7% to 5.5%. The only statistically significant association was that between R. slovaca seropositivity and age. We present serologic evidence of R. slovaca infection among population of Catalonia, northeast of Spain.

Spotted fever group Rickettsia in ticks from southeastern Spain natural parks

During an 8-years study, we collected from vegetation or domestic and wild mammals 1246 ticks (624 males, 511 females and 111 nymphs) belonging to 13 species in Jaen province (Andalusia) and we analyzed these ticks by PCR and sequencing for the presence of rickettsiae. Specific rickettsiae DNA was detected in 243 (19.5%) of the ticks tested. Sequence analysis of amplicons of gltA, ompA and ompB genes revealed that Ixodes ricinus were infected with R. monacensis, including strain IRS3, and R. helvetica (prevalences of 27.0% and 2.7%, respectively), while in I. ventalloi we found only this last species (12.5%). Moreover, Dermacentor marginatus presents R. slovaca (24.7%) and R. raoultii (59.9%). In Rhipicephalus sanguineus group ticks (Rh. sanguineus, Rh. turanicus and Rh. pusillus) only R. massiliae (15.2%) was found. Haemaphysalis punctata and Ha. sulcata were infected with a Rickettsia sp. near R. hoogstraalii (prevalence of 3.1% and 16.1%, respectively). In addition, Ha. punctata appeared infected with R. monacensis-like Rickettsia (1.0%) and R. raoultii (9.3%). None of I. hexagonus, Hyalomma lusitanicum, Hyalomma sp., Ha. hispanica or Rh. bursa studied ticks contained rickettsiae.