Spotted fever group rickettsiae (SFGR) detection in ticks following reported human case of Japanese spotted fever in Niigata Prefecture, Japan.

Japanese spotted fever, a tick-borne disease caused by Rickettsia japonica, was firstly described in southwestern Japan. There was a suspicion of Rickettsia japonica infected ticks reaching the non-endemic Niigata Prefecture after a confirmed case of Japanese spotted fever in July 2014. Therefore, from 2015 to 2017, 38 sites were surveyed and rickettsial pathogens were investigated in ticks from north to south of Niigata Prefecture including Sado island. A total of 3336 ticks were collected and identified revealing ticks of three genera and ten species: Dermacentor taiwanensis, Haemaphysalis flava, Haemaphysalis hystricis, Haemaphysalis longicornis, Haemaphysalis megaspinosa, Ixodes columnae, Ixodes monospinosus, Ixodes nipponensis, Ixodes ovatus, and Ixodes persulcatus. Investigation of rickettsial DNA showed no ticks infected by R. japonica. However, three species of spotted fever group rickettsiae (SFGR) were found in ticks, R. asiatica, R. helvetica, and R. monacensis, confirming Niigata Prefecture as a new endemic area to SFGR. These results highlight the need for public awareness of the occurrence of this tick-borne disease, which necessitates the establishment of public health initiatives to mitigate its spread.

Detection of Novel Spotted Fever Group Rickettsiae (Rickettsiales: Rickettsiaceae) in Ticks (Acari: Ixodidae) in Southwestern China.

Spotted fever group rickettsiae, mainly maintained and transmitted by ticks, are important etiological agents of (re)emerging zoonotic diseases worldwide. It is of great significance to investigate spotted fever group rickettsiae in ticks in different areas for the prevention and control of rickettsioses. In this study, a total of 305 ticks were collected from wild and domestic animals in Chongqing, Guizhou, Yunnan, and Guangxi provinces of southwestern China during 2017-2019 and examined for the presence of spotted fever group rickettsiae by PCR with primers targeting the partial gltA, ompA, rrs, and htrA genes. Results showed that two spotted fever group rickettsiae species, including the pathogenic Candidatus Rickettsia jingxinensis (Rickettsiales: Rickettsiaceae) and a potential novel species Rickettsia sp. sw (Rickettsiales: Rickettsiaceae), were identified. The Ca. R. jingxinensis sequences were recovered from Rhipicephalus microplus (Ixodida: Ixodidae) and Haemaphysalis longicornis (Ixodida: Ixodidae) ticks and phylogenetically clustered with previous Ca. R. jingxinensis, Ca. R. longicornii (Rickettsiales: Rickettsiaceae), and Rickettsia sp. XY118 (Rickettsiales: Rickettsiaceae) strains. Rickettsia sp. sw was detected in Amblyomma geoemydae (Ixodida: Ixodidae) and Rh. microplus. Interestingly, as far as we know, this was the first report of Rickettsia (Rickettsiales: Rickettsiaceae) in A. geoemydae. Phylogenetic analyses indicated that this potential novel species was closely related to R. aeschlimannii (Rickettsiales: Rickettsiaceae) with gltA and ompA genes and grouped in a cluster composed of R. montanensis (Rickettsiales: Rickettsiaceae), R. raoultii (Rickettsiales: Rickettsiaceae), R. aeschlimannii, R. massiliae (Rickettsiales: Rickettsiaceae), and R. rhipicephali (Rickettsiales: Rickettsiaceae) with htrA, while formed a separate clade with rrs. The pathogenicity of Rickettsia sp. sw should be further confirmed. These results expand the knowledge of the geographical distribution and vector distribution of spotted fever group rickettsiae in China and are useful for assessing the potential public health risk.

Spotted fever group rickettsiae transmitted by Dermacentor ticks and determinants of their spread in Europe.

Rickettsiae from the spotted fever group, i.e. the etiological agents of tick-borne lymphadenopathy/Dermacentor-borne necrotic erythema and lymphadenopathy (TIBOLA /DEBONEL) syndrome, are associated with ticks, including Dermacentor marginatus and Dermacentor reticulatus. The expansion of these ticks into new areas increases the risk of infection of their hosts with tick-borne pathogens. The study summarises the importance of 2 species from the genus Dermacentor, i.e. D. marginatus and D. reticulatus, in the spread of spotted fever group rickettsiae in various regions of Europe. The study also focuses on the determinants of the presence of vectors and transmission of rickettsiae, as well as the effects of human infections with these pathogens. The climate changes observed nowadays affect vectors and increase the incidence and spread of tick-borne diseases worldwide. Due to the existing risk of exposure to an increasing number of people, knowledge about the course of these serious diseases and their etiological factors should be disseminated among healthcare professionals as well as in society. There is a great challenge for epidemiological services to provide access to medical and veterinary facilities in order to diagnose and treat rickettsioses. Therefore, the development of a strategy for tick control and the popularisation of knowledge concerning prophylaxis of tick-borne diseases is indispensable.

New Jersey-Wide Survey of Spotted Fever Group Rickettsia (Proteobacteria: Rickettsiaceae) in Dermacentor variabilis and Amblyomma americanum (Acari: Ixodida: Ixodidae).

For the last decade, the New Jersey (NJ) Department of Health has reported between 42 and 144 new cases each year of "spotted fever group rickettsiosis" (SFGR), a statistic that reflects uncertainty regarding which rickettsial agents (Proteobacteria: Rickettsiaceae: Rickettsia) are infecting NJ residents. To identify the Rickettsia circulating in NJ ticks, we used a combination of conventional and real time PCR approaches to screen 560 Dermacentor variabilis Say and 245 Amblyomma americanum L. obtained from a 1-day state-wide surveillance in May 2018 and an additional 394 D. variabilis collected across NJ in 2013-2018. We found zero D. variabilis infected with Rickettsia rickettsii, the agent of Rocky Mountain spotted fever and, on average, 1.3% infected with presumed nonpathogenic Rickettsia montanensis. We also found zero A. americanum infected with R. rickettsii, and 20% infected with Rickettsia amblyommatis, a prevalence somewhat lower than in more southern states. Overall, we conclude that it is unlikely that R. rickettsii vectored by D. variabilis is a primary cause of SFGR cases in NJ and discuss our findings in the context of known facts and current limitations. We conclude that understanding the causes of SFGR east of the Mississippi will require collaboration among medical doctors, public health authorities, and medical entomologists to follow up presumptive human cases of SFGR with detailed histories of exposure, species-specific molecular assays, and active surveillance of putative vectors and the pathogens they may carry.

Invasive plants facilitated by socioeconomic change harbor vectors of scrub typhus and spotted fever.

BACKGROUND: Ecological determinants of most emerging vector-borne diseases are understudied, particularly for neglected tropical disease. Moreover, although socioeconomic impacts can have significant downstream effects on human risks to vector-borne diseases via a change in land cover, particularly facilitating the invasion of exotic plants, related studies remains very scarce. Scrub typhus and spotted fever are neglected diseases emerging around the globe and are transmitted by chigger mites and ticks infective of Orientia tsutsugamushi and Rickettsia spp., respectively, with small mammals as the primary hosts of both vectors. METHODOLOGY/PRINCIPAL FINDINGS: We investigated how invasions of the plant Leucaena leucocephala caused by widespread abandonment of farmlands driven by industrialization affected abundance of chiggers and ticks in Penghu Island, Taiwan. We determined ectoparasite abundance by trapping small mammals in three types of habitats (invasion site, agricultural field, human residential) every two months for a year. Based on ectoparasite burdens, invasion sites harbored more chiggers and ticks than the other two habitats. Furthermore, hosts maintained higher burdens of both vectors in early winter and burdens of chiggers were more stable across seasons in invasion sites, suggesting that sites with invasive plants could be a temporary refuge for both vectors and might help mitigate the negative influence of unfavorable climate. Infective rates of O. tsutsugamushi in chiggers and Rickettsia in ticks were also consistently not lower in invasion sites. Top soil temperature and relative humidity were similar across the three habitats, but invasion sites contained more of the rat Rattus losea, on which chiggers and ticks were more engorged than those from the most commonly trapped species (Suncus murinus shrew), indicating that abundance of the host R. losea instead of microclimate might better determine the abundance of both vectors. CONCLUSIONS/SIGNIFICANCE: This study highlights an important but largely neglected issue that socioeconomic change can have unexpected consequences for human health induced particularly by invasive plants, which could become a hotspot for emerging infectious diseases but usually are very hard to be eradicated. In the future, a more comprehensive approach that integrates socio-economics, land use, exotic species, and human health should be considered to fully understand potential emergence of vector-borne diseases.

Distribution and Ecological Drivers of Spotted Fever Group Rickettsia in Asia.

Spotted fever group and related rickettsia (SFGR) are a neglected group of pathogens that belong to the genus Rickettsia. SFGR are zoonotic and are transmitted by arthropod vectors, primarily ticks, fleas and mites to accidental hosts. These emerging and re-emerging infections are widely distributed throughout the world. Land-use change and increasing human-wildlife conflict compound the risk of SFGR infection to local people in endemic areas and travelers to these regions. In this article, we discuss the rickettsial organisms causing spotted fever and related diseases, their arthropod vectors in Asia and the impact of land-use change on their spread.

Molecular detection of spotted fever group rickettsiae in hard ticks, northern China.

Spotted fever group (SFG) rickettsiae are important causative agents of (re)emerging tick-borne infectious diseases in humans, and ticks play a key role in their maintenance and transmission. In this study, hard ticks were collected from five sampling sites in North China in 2017 and 2018. Of them, Haemaphysalis longicornis, Rhipicephalus microplus and Dermacentor nuttalli were collected from livestock (sheep and goats) and the vegetation, Hyalomma asiaticum from sheep, goats and camels, and Hyalomma marginatum from sheep and goats. The SFG rickettsiae were identified in these ticks by amplifying the partial rrs and complete 17-kDa genes, with an overall infection rate of 52.9%. In addition, the nearly full-length rrs and gltA and partial ompA genes were recovered to classify the species of SFG rickettsiae further. Phylogenetic analysis revealed the presence of three human pathogenic species in Hy. asiaticum, Hy. marginatum, Ha. longicornis and De. nuttalli, including two cultured ones (Rickettsia raoultii and Rickettsia aeschlimannii) and one uncultured (Candidatus R. jingxinensis). Furthermore, partial groEL gene was also obtained, and phylogenetic trees were also reconstructed to better understand the genetic relationship with known sequences in each SFG rickettsiae species detected in the current study. Notably, the R. aeschlimannii sequences described in this study were closely related to those from abroad rather than from another part of China, indicating their different origin. However, the R. raoultii and Ca. R. jingxinensis sequences presented close relationship with variants from other parts of China. In sum, our data revealed SFG rickettsiae species in northern China, highlighting the need for surveillance of their infection in local humans.

Molecular detection of a novel Babesia sp. and pathogenic spotted fever group rickettsiae in ticks collected from hedgehogs in Turkey: Haemaphysalis erinacei, a novel candidate vector for the genus Babesia.

In this study, a total of 319 ticks were obtained from hedgehogs (Erinaceus concolor). All ticks were pooled into groups and screened by PCR for tick-borne pathogens (TBPs). PCR and sequence analyses identified the presence of a novel Babesia sp. in adult Haemaphysalis erinacei. In addition, the presence of natural transovarial transmission of this novel Babesia sp. was detected in Ha. erinacei. According to the 18S rRNA (nearly complete) and partial rRNA locus (ITS-1/5.8S/ITS-2) phylogeny, it was determined that this new species is located within the Babesia sensu stricto clade and is closely related to Babesia spp. found in carnivores. Furthermore, the presence of three pathogenic spotted fever group (SFG) rickettsiae was determined in 65.8% of the tick pools: Rickettsia sibirica subsp. mongolitimonae in Hyalomma aegyptium (adult), Hyalomma spp. (larvae), Rhipicephalus turanicus (adult), and Ha. erinacei (adult); Rickettsia aeschlimannii in H. aegyptium (adult); Rickettsia slovaca in Hyalomma spp. (larvae and nymphs) and H. aegyptium (adult). To our knowledge, this is the first report of R. sibirica mongolitimonae in H. aegyptium, Ha. erinacei, and Rh. turanicus, and the first report of R. slovaca in H. aegyptium. In addition, the presence of a single Hemolivia mauritanica haplotype was detected in H. aegyptium adults. Consequently, the presence of a novel Babesia sp. has been identified in a new candidate vector tick species in this study. Additionally, three SFG rickettsiae that cause infections in humans were identified in ticks collected from hedgehogs. Therefore, environmental wildlife monitoring for hedgehogs should be carried out for ticks and tick-borne pathogens in the region. Additionally, studies regarding the reservoir status of hedgehogs for the aforementioned pathogens must be carried out.

Spotted Fever Group Rickettsia Infection and Transmission Dynamics in Amblyomma maculatum.

Tick vectors are capable of transmitting several rickettsial species to vertebrate hosts, resulting in various levels of disease. Studies have demonstrated the transmissibility of both rickettsial pathogens and novel Rickettsia species or strains with unknown pathogenicity to vertebrate hosts during tick blood meal acquisition; however, the quantitative nature of transmission remains unknown. We tested the hypothesis that if infection severity is a function of the rickettsial load delivered during tick transmission, then a more virulent spotted fever group (SFG) Rickettsia species is transmitted at higher levels during tick feeding. Using Amblyomma maculatum cohorts infected with Rickettsia parkeri or "Candidatus Rickettsia andeanae," a quantitative PCR (qPCR) assay was employed to quantify rickettsiae in tick salivary glands and saliva, as well as in the vertebrate hosts at the tick attachment site over the duration of tick feeding. Significantly greater numbers of R. parkeri than of "Ca Rickettsia andeanae" rickettsiae were present in tick saliva and salivary glands and in the vertebrate hosts at the feeding site during tick feeding. Microscopy demonstrated the presence of both rickettsial species in tick salivary glands, and immunohistochemical analysis of the attachment site identified localized R. parkeri, but not "Ca Rickettsia andeanae," in the vertebrate host. Lesions were also distinct and more severe in vertebrate hosts exposed to R. parkeri than in those exposed to "Ca Rickettsia andeanae." The specific factors that contribute to the generation of a sustained rickettsial infection and subsequent disease have yet to be elucidated, but the results of this study suggest that the rickettsial load in ticks and during transmission may be an important element.

Vector Tick Transmission Model of Spotted Fever Rickettsiosis.

Many aspects of rickettsial infections have been characterized, including pathogenic and immune pathways and mechanisms of rickettsial survival within the vertebrate host and tick vector. However, very few studies are focused on the complex pathogen-vector-host interactions during tick feeding. Therefore, our objective was to develop a tick transmission model of the spotted fever group of rickettsial infections to study the initial events in disease development. The most appropriate strain of mouse was identified for evaluation as a transmission model, and the course of infection, bacterial levels, histopathologic changes, and antibody response during tick transmission in mice infested with Amblyomma maculatum ticks carrying the emerging pathogen, Rickettia parkeri, were studied. Results showed distinct clinical signs in C3H/HeN mice infected intravenously, leading to selection of this mouse strain for tick transmission studies. Active infection of animals was observed after tick vector transmission. The bacteria disseminated systemically and spread to several organs at 24 hours after tick attachment, with peak bacterial load at day 6 after tick attachment. Skin, lung, and liver showed the greatest pathologic changes, with inflammatory cellular infiltration and necrosis. These findings indicate the feasibility of using murine infection with R. parkeri by A. maculatum tick transmission as a model to study different aspects of the spotted fever group of rickettsial disease establishment.

First molecular detection of the human pathogen Rickettsia raoultii and other spotted fever group rickettsiae in Ixodid ticks from wild and domestic mammals.

Tick-borne rickettsioses are recognized as emerging vector-borne infections capable of infecting both human and animal hosts worldwide. This study focuses on the detection and molecular identification of species belonging to the genus Rickettsia in ticks sampled from human, vegetation, and domestic and wild vertebrates in Sardinia. Ticks were tested by PCR targeting gltA, ompA, and ompB genes, followed by sequencing analysis. The results provide evidences of a great variety of Rickettsia species of the Spotted fever group in Ixodid ticks and allow establishing for the first time the presence of R. raoultii in Rhipicephalus sanguineus s.l. and Dermacentor marginatus ticks in Sardinia island. Rickettsia massiliae was detected on R. sanguineus s.l. and R. aeschlimannii in Hyalomma marginatum and Hy. lusitanicum ticks. In addition, eight D. marginatus ticks were positive for R. slovaca. This study provides further evidence that different Rickettsia species are widespread in Sardinian ticks and that detailed investigations are required to understand the role these tick species play on spotted fever group rickettsiae circulation. More studies will provide new background on molecular epidemiology of zoonotic rickettsiae, the geographical distribution of tick-transmitted rickettsial pathogens, and the involvement of vertebrate hosts in propagation and maintenance of these bacteria in nature.

[Autochthonous case of spotted fever caused by Rickettsia parkeri in Ensenada, Buenos Aires]. / Caso autóctono de fiebre manchada por Rickettsia parkeri en Ensenada, Buenos Aires.

We present a case of spotted fever occurred in an adult residing in Ensenada, Buenos Aires province in February 2016. The patient presented with an acute febrile syndrome associated with a skin necrotic lesion on the left leg secondary to a tick bite. The general symptoms were a maculopapular rash, headache, myalgia, and arthralgias. Seroconversion of anti-Rickettsia specific IgG antibodies confirmed recent infection. The nucleotidic and aminoacidic sequences of a gltA gen fragment matched 100% the sequences of R. parkeri strains from Argentina and other countries of America. The patient responded well to treatment with doxycycline.

Diagnosis of Spotted Fever Group Rickettsioses in U.S. Travelers Returning from Africa, 2007-2016.

Spotted fever group rickettsioses (SFGRs), such as African tick bite fever (ATBF), are among the most commonly diagnosed diseases for ill travelers returning from southern Africa. We summarized demographic, clinical, and diagnostic features of imported SFGR cases in U.S. travelers returning from Africa who had laboratory specimens submitted to the Centers for Disease Control and Prevention. Diagnosis of SFGR was performed by indirect immunofluorescence antibody assay, immunohistochemical staining, polymerase chain reaction (PCR), or culture. Cases were defined as probable SFGR, confirmed SFGR, or confirmed ATBF. Clinical and epidemiological categorical variables were described as counts and proportions; continuous variables were described using geometric mean titers, median, and range. One hundred and twenty-seven patients satisfied laboratory criteria for confirmed or probable SFGR. Fever was the most common symptom (N = 88; 69%), followed by ≥ 1 eschars (N = 70; 55%). Paired serums were submitted for 36 patients (28%); 12 patients (33%) had nonreactive initial serum sample but converted to a titer ≥ 64 with the convalescent sample. Twenty-seven patients (21%) had infection with Rickettsia africae based on PCR analysis of eschar swab (N = 8) or biopsy (N = 23). Fifteen patients had eschar biopsy or swab samples and serum sample(s) submitted together; 9 (60%) had PCR-positive eschar results and nonreactive acute serology. Health-care providers should consider SFGR when evaluating patients for a febrile illness with eschar and compatible foreign travel history. Polymerase chain reaction testing of eschar biopsies or swabs provides a confirmed diagnosis in early stages of disease; eschar swabs or biopsies are an underutilized diagnostic technique.

Caso autóctono de fiebre manchada por Rickettsia parkeri en Ensenada, Buenos Aires / Autochthonous case of spotted fever caused by Rickettsia parkeri in Ensenada, Buenos Aires

Se comunica un caso autóctono de fiebre manchada por Rickettsia parkeri en un adulto residente en Ensenada, Provincia de Buenos Aires ocurrido en el verano de 2016. El cuadro, secundario a una mordedura de garrapata en la pierna izquierda, se presentó como un síndrome febril agudo con deterioro del estado general, cefalea, mialgias, artralgias y exantema maculopapular. El sitio de la mordedura presentaba una úlcera con escara necrótica. El diagnóstico se confirmó por conversión serológica IgG anti-antígenos del género Rikettsia. La secuencia de un fragmento del gen gltA amplificado a partir de la lesión de piel presentó 100% identidad nucleotídica con las secuencias de cepas de R. parkeri aisladas en Argentina y en varios países de América. El paciente evolucionó favorablemente al tratamiento con doxiciclina.

We present a case of spotted fever occurred in an adult residing in Ensenada, Buenos Aires province in February 2016. The patient presented with an acute febrile syndrome associated with a skin necrotic lesion on the left leg secondary to a tick bite. The general symptoms were a maculopapular rash, headache, myalgia, and arthralgias. Seroconversion of anti-Rickettsia specific IgG antibodies confirmed recent infection. The nucleotidic and aminoacidic sequences of a gltA gen fragment matched 100% the sequences of R. parkeri strains from Argentina and other countries of America. The patient responded well to treatment with doxycycline.

New records of tick-associated spotted fever group Rickettsia in an Amazon-Savannah ecotone, Brazil.

Human rickettsiosis has been recorded in the Amazon Biome. However, the epidemiological cycle of causative rickettsiae has not been fully accounted for in the Amazon region. This study investigates the presence of spotted fever group (SFG) Rickettsia spp. in free-living unfed ticks of the Amblyomma genus. The study was conducted in seven municipalities in Rondonia State, Brazil, where the main biomes are Amazon forest, Brazilian Savannah and their ecotones (areas of ecological tension between open ombrophilous forest and savannah). The following tick species were collected: Amblyomma cajennense (sensu lato) s.l., A. cajennense (sensu stricto) s.s., A. coelebs, A. naponense, A. oblongoguttatum, A. romitii, A. scalpturatum and A. sculptum. A total of 167 adults, 248 nymphs and 1004 larvae were subjected to DNA extraction and polymerase chain reaction (PCR) to determine the presence of SFG Rickettsia spp. PCR-positive samples included: one A. cajennense s.s. female and one A. cajennense s.l. male from a rural area in Vilhena Municipality; 10 nymphs and a sample of larvae of A. cajennense s.l. from a peri-urban area in Cacoal Municipality; and an A. oblongoguttatum adult male from a rural area of Pimenta Bueno Municipality. All sequences obtained exhibited 100% identity with Rickettsia amblyommatis sequences. This is the first confirmation of SFG Rickettsia in an A. oblongoguttatum tick. Furthermore, this is the first record of SFG Rickettsia in the municipalities targeted by this study. These results warn that SFG Rickettsia circulation poses a threat in Rondonia State (among Amazon-Savannah ecotones), and that this threat is increased by the fact that SFG Rickettsia infect a human-biting tick species hitherto unconfirmed as a vector.

Molecular detection of spotted fever group rickettsiae in ticks from Cameroon.

In western and eastern Africa, rickettsioses are one cause of fever in humans. Little is known regarding the presence of Rickettsia sp. in northern Cameroon. The present work was conducted in order to identify potential tick-borne spotted fever group Rickettsia in the Adamawa region of northern Cameroon, which may contribute filling some of the knowledge gaps of these pathogens. Ticks were collected from cattle in the municipal slaughterhouse of Ngaoundere in the Adamawa region of northern Cameroon. After morphological identification of tick species, extracted DNA was analyzed by PCR targeting the rickettsial ompB gene and the intergenic spacers dksA-xerC, mppA-purC and rpmE-tRNAfMet. Of the 316 adult ticks collected, 149 (47.1%) were Amblyomma variegatum, 92 (29%) Rhipicephalus spp. and 75 (23.7%) Hyalomma spp. Through the use of conventional PCR assays for the rickettsial ompB gene, rickettsial DNA was detected in 104 (32.9%) samples (85 Amblyomma sp., 14 Hyalomma spp. and 5 Rhipicephalus spp.). The ompB gene and the three intergenic were sequenced for 10 ticks in order to determine the rickettsial species. Rickettsia africae was detected in Amblyomma variegatum, Rickettsia aeschlimannii in Hyalomma rufipes and Hyalomma truncatum, Rickettsia sibirica in H. truncatum, Rickettsia massiliae in Rhipicephalus lunulatus and Candidatus Rickettsia barbariae in R. lunulatus. To the best of the author's knowledge, this report represents the first molecular evidence of rickettsial infection in ticks in the Adamawa region of northern Cameroon, which suggests a possible exposure of the human population in this region.

Distribution of tick-borne diseases in Japan: Past patterns and implications for the future.

The rapid geographical spread of tick-borne diseases (TBDs) worldwide has recently provoked significant concerns amongst public health authorities. Tick-borne pathogens are maintained in enzootic cycles involving ticks and wild animal hosts, with epizootic spread to other mammals, including livestock and humans. Despite the increasing public health concern, current TBD diagnostic tests and treatments are inadequate, and predictive models of future risks posed by TBDs are limited by the heterogeneity of environmental, vector, and host factors, even in neighboring regions. In recent years, infections resulting in severe fever with thrombocytopenia syndrome (SFTS), Japanese spotted fever, and the scrub typhus pathogens have been reported frequently in addition to traditional TBDs in Japan. The Japanese archipelago is extremely elongated from north to south and its climate varies considerably, creating remarkable regional differences in tick species. The importance of continuous surveillance of TBDs has been growing in terms of geopathology - studies dealing with the relationships between geographic factors and the causes of specific diseases - in Japan and neighboring areas among eastern Asian countries, including China and Korea. In this review, we summarize detailed information regarding the history and epidemic status of human TBDs in Japan.

Human Infection with Novel Spotted Fever Group Rickettsia Genotype, China, 2015.

Only 4 species of spotted fever group rickettsiae have been detected in humans in China. However, phylogenetic analysis of samples from 5 ill patients in China indicated infection with a novel spotted fever group Rickettsia, designated Rickettsia sp. XY99. Clinical signs resembled those of severe fever with thrombocytopenia syndrome.