Analyze Diet

Prevalence of antibodies to spotted fever group rickettsiae in humans and domestic animals in a Brazilian spotted fever-endemic area in the state of São Paulo, Brazil: serologic evidence for infection by Rickettsia rickettsii and another spotted fever group Rickettsia.

Abstract: In serum samples obtained from all the healthy humans, horses, dogs, and donkeys present on three farms in the Pedreira Municipality, an endemic area for Brazilian spotted fever, an indirect immunofluorescence assay (IFA) detected antibodies against Rickettsia rickettsii in 17 (77.3%) horses, 5 (31.3%) dogs (titers ranging from 64 to 4,048), and none of 4 donkeys or 50 humans. Five canine and eight equine sera with high antibody titers to R. rickettsii were also tested by IFA against R. bellii, R. akari, and R. africae antigens. Sera from two horses and two dogs that showed similar high antibody titers against two rickettsial antigens were evaluated after cross-absorption. Sera from seven horses and two dogs contained antibodies specific for R. rickettsii, and one dog serum had antibodies against a Rickettsia species very closely related to R. africae. The latter may have been caused by infection with the recently identified COOPERI strain.
Publication Date: 2004-07-09 PubMed ID: 15238696
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article
  • Research Support
  • Non-U.S. Gov't
  • Research Support
  • U.S. Gov't
  • P.H.S.

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigated the prevalence of antibodies against spotted fever group rickettsiae in humans and certain domestic animals in a region known for Brazilian spotted fever. The study found that a significant number of horses and some dogs had antibodies against Rickettsia rickettsii, indicating previous exposure to the bacteria, while none of the humans or donkeys showed such evidence.

Study Design and Methods

  • The research was conducted on three farms in the Pedreira Municipality, an area endemic for Brazilian spotted fever.
  • Serum samples were collected from all individuals (humans and animals) and tested using an indirect immunofluorescence assay (IFA). The IFA was designed to detect antibodies against Rickettsia rickettsii – the bacterium responsible for causing spotted fever.
  • The test was conducted on horses, dogs, donkeys, and humans present on the farms.
  • Certain canine and equine sera with high R. rickettsii antibody titers were tested further against R. bellii, R. akari, and R. africae antigens.
  • The researchers carried out additional tests (cross-absorption) on the serum of animals exhibiting high antibody titers against two rickettsial antigens.

Results and Conclusions

  • The prevalence of Rickettsia rickettsii antibodies was found to be 77.3% in horses and 31.3% in dogs. None were found in donkeys or the human population.
  • Further tests on canine and equine sera with high R. rickettsii antibody titers showed specificity for R. rickettsii in seven horses and two dogs.
  • Significantly, one dog serum showed antibodies against a Rickettsia species highly related to R. africae, indicating potential infection from the COOPERI strain.
  • These findings highlight the immunity or resistance these animals have developed towards the disease, possibly due to repeated exposure to the bacterium. It also indicates that the disease is prevalent in the locality and poses a potential risk if protective measures are not maintained.
  • The results provide strong serologic evidence for infection by Rickettsia rickettsii and potentially another spot fever group Rickettsia, helping the scientific community gain better understanding of the disease landscape in this region and the potential threats it poses.

Cite This Article

APA
Horta MC, Labruna MB, Sangioni LA, Vianna MC, Gennari SM, Galvão MA, Mafra CL, Vidotto O, Schumaker TT, Walker DH. (2004). Prevalence of antibodies to spotted fever group rickettsiae in humans and domestic animals in a Brazilian spotted fever-endemic area in the state of São Paulo, Brazil: serologic evidence for infection by Rickettsia rickettsii and another spotted fever group Rickettsia. Am J Trop Med Hyg, 71(1), 93-97.

Publication

ISSN: 0002-9637
NlmUniqueID: 0370507
Country: United States
Language: English
Volume: 71
Issue: 1
Pages: 93-97

Researcher Affiliations

Horta, Maurício C
  • Faculty of Veterinary Medicine, and Department of Parasitology, University of São Paulo, São Paulo, Brazil.
Labruna, Marcelo B
    Sangioni, Luis A
      Vianna, Manoella C B
        Gennari, Solange M
          Galvão, Márcio A M
            Mafra, Claudio L
              Vidotto, Odilon
                Schumaker, Teresinha T S
                  Walker, David H

                    MeSH Terms

                    • Animals
                    • Animals, Domestic / microbiology
                    • Antibodies, Bacterial / blood
                    • Brazil / epidemiology
                    • Dogs
                    • Endemic Diseases
                    • Fluorescent Antibody Technique
                    • Horses
                    • Humans
                    • Prevalence
                    • Rickettsia Infections / epidemiology
                    • Rickettsia Infections / microbiology
                    • Rickettsia Infections / veterinary
                    • Rickettsia rickettsii / immunology
                    • Rocky Mountain Spotted Fever / blood
                    • Rocky Mountain Spotted Fever / epidemiology
                    • Rocky Mountain Spotted Fever / microbiology
                    • Seroepidemiologic Studies

                    Grant Funding

                    • D43 TW 00903 / FIC NIH HHS

                    Citations

                    This article has been cited 44 times.
                    1. França DA, Mioni MSR, Fornazari F, Rodrigues NJL, Polido LRF, Appolinario CM, Ribeiro BLD, Duré AÍL, Silva MVF, Richini-Pereira VB, Langoni H, Megid J. Comparison of Three Serologic Tests for the Detection of Anti-Coxiella burnetii Antibodies in Patients with Q Fever. Pathogens 2023 Jun 26;12(7).
                      doi: 10.3390/pathogens12070873pubmed: 37513720google scholar: lookup
                    2. Neves LC, Paula WVF, de Paula LGF, da Silva BBF, Dias SA, Pereira BG, Silva BSA, Sevá ADP, Dantas-Torres F, Labruna MB, Krawczak FDS. Detection of Rickettsia spp. in Animals and Ticks in Midwestern Brazil, Where Human Cases of Rickettsiosis Were Reported. Animals (Basel) 2023 Apr 9;13(8).
                      doi: 10.3390/ani13081288pubmed: 37106851google scholar: lookup
                    3. Muniz APM, Tolesano-Pascoli G, Vieira RBK, Polli MG, Rodrigues VDS, Gonzaga HT, Mamede CCN, Da Cunha NC, Szabó MJP, Yokosawa J. Evaluation of a mimotope of the Rickettsia outer membrane protein A (OmpA) as an antigen in enzyme-linked immunosorbent assay to detect rickettsiosis in capybaras (Hydrochoerus hydrochaeris), horses (Equus caballus), and opossums (Didelphis sp.). Exp Appl Acarol 2023 Feb;89(2):317-327.
                      doi: 10.1007/s10493-023-00776-5pubmed: 36795267google scholar: lookup
                    4. Bonilla-Aldana DK, Castaño-Betancourt KJ, Ortega-Martínez JM, Ulloque-Badaracco JR, Hernandez-Bustamante EA, Benites-Zapata VA, Rodriguez-Morales AJ. Prevalence of zoonotic and non-zoonotic Rickettsia in horses: A systematic review and meta-analysis. New Microbes New Infect 2023 Jan;51:101068.
                      doi: 10.1016/j.nmni.2022.101068pubmed: 36632173google scholar: lookup
                    5. Campos JBV, Martins FS, Macedo GC, Barreto WTG, Oliveira CE, Barbieri ARM, Labruna MB, Oliveira-Santos LGR, Herrera HM. Serological exposure of spotted fever group Rickettsia in capybaras (Hydrochoerus hydrochaeris) from urban parks in Campo Grande, Brazilian Midwest. Rev Soc Bras Med Trop 2022;55:e0192.
                      doi: 10.1590/0037-8682-0192-2022pubmed: 36134865google scholar: lookup
                    6. França DA, Mioni MSR, Fornazari F, Duré AÍL, Silva MVF, Possebon FS, Richini-Pereira VB, Langoni H, Megid J. Seropositivity for Coxiella burnetii in suspected patients with dengue in São Paulo state, Brazil. PLoS Negl Trop Dis 2022 May;16(5):e0010392.
                      doi: 10.1371/journal.pntd.0010392pubmed: 35536865google scholar: lookup
                    7. Mioni MSR, Costa FB, Ribeiro BLD, Teixeira WSR, Pelicia VC, Labruna MB, Rousset É, Sidi-Boumedine K, Thiéry R, Megid J. Coxiella burnetii in slaughterhouses in Brazil: A public health concern. PLoS One 2020;15(10):e0241246.
                      doi: 10.1371/journal.pone.0241246pubmed: 33125388google scholar: lookup
                    8. Barradas PF, Neto Z, Mateus TL, Teodoro AC, Duarte L, Gonçalves H, Ferreira P, Gärtner F, Sousa R, Amorim I. Serological Evidence of Rickettsia Exposure among Patients with Unknown Fever Origin in Angola, 2016-2017. Interdiscip Perspect Infect Dis 2020;2020:4905783.
                      doi: 10.1155/2020/4905783pubmed: 32908499google scholar: lookup
                    9. Luz HR, Costa FB, Benatti HR, Ramos VN, de A Serpa MC, Martins TF, Acosta ICL, Ramirez DG, Muñoz-Leal S, Ramirez-Hernandez A, Binder LC, Carvalho MP, Rocha V, Dias TC, Simeoni CL, Brites-Neto J, Brasil J, Nievas AM, Monticelli PF, Moro MEG, Lopes B, Aguiar DM, Pacheco RC, Souza CE, Piovezan U, Juliano R, Ferraz KMPMB, Szabó MPJ, Labruna MB. Epidemiology of capybara-associated Brazilian spotted fever. PLoS Negl Trop Dis 2019 Sep;13(9):e0007734.
                      doi: 10.1371/journal.pntd.0007734pubmed: 31490924google scholar: lookup
                    10. Pacheco-Solano K, Barrantes-González A, Dolz G, Troyo A, Jiménez-Rocha AE, Romero-Zuñiga JJ, Taylor L. Exposure of dogs to Rickettsia spp. in Costa Rica: Risk factors for PCR-positive ectoparasites and seropositivity. Parasite Epidemiol Control 2019 Nov;7:e00118.
                      doi: 10.1016/j.parepi.2019.e00118pubmed: 31489383google scholar: lookup
                    11. Kmetiuk LB, Krawczak FS, Machado FP, Paploski IAD, Martins TF, Teider-Junior PI, Serpa MCA, Barbieri ARM, Bach RVW, Barros-Filho IR, Lipinski LC, P Dos Santos A, Labruna MB, Biondo AW. Ticks and serosurvey of anti-Rickettsia spp. antibodies in wild boars (Sus scrofa), hunting dogs and hunters of Brazil. PLoS Negl Trop Dis 2019 May;13(5):e0007405.
                      doi: 10.1371/journal.pntd.0007405pubmed: 31145746google scholar: lookup
                    12. Ferreira LL, Sarria ALF, de Oliveira Filho JG, de Silva FO, Powers SJ, Caulfield JC, Pickett JA, Birkett MA, Borges LMF. Identification of a non-host semiochemical from tick-resistant donkeys (Equus asinus) against Amblyomma sculptum ticks. Ticks Tick Borne Dis 2019 Apr;10(3):621-627.
                      doi: 10.1016/j.ttbdis.2019.02.006pubmed: 30799282google scholar: lookup
                    13. Alhassan A, Liu H, McGill J, Cerezo A, Jakkula LUMR, Nair ADS, Winkley E, Olson S, Marlow D, Sahni A, Narra HP, Sahni S, Henningson J, Ganta RR. Rickettsia rickettsii Whole-Cell Antigens Offer Protection against Rocky Mountain Spotted Fever in the Canine Host. Infect Immun 2019 Feb;87(2).
                      doi: 10.1128/IAI.00628-18pubmed: 30396898google scholar: lookup
                    14. Quintero Vélez JC, Aguirre-Acevedo DC, Rodas JD, Arboleda M, Troyo A, Vega Aguilar F, Osorio Quintero L, Rojas Arbeláez C. Epidemiological characterization of incident cases of Rickettsia infection in rural areas of Urabá region, Colombia. PLoS Negl Trop Dis 2018 Oct;12(10):e0006911.
                      doi: 10.1371/journal.pntd.0006911pubmed: 30379820google scholar: lookup
                    15. Brustolin JM, da Silva Krawczak F, Alves MEM, Weiller MA, de Souza CL, Rosa FB, Cadore GC, Dos Anjos Lopes ST, Labruna MB, Vogel FSF, de Avila Botton S, Sangioni LA. Experimental infection in Cavia porcellus by infected Amblyomma ovale nymphs with Rickettsia sp. (Atlantic rainforest strain). Parasitol Res 2018 Mar;117(3):713-720.
                      doi: 10.1007/s00436-017-5741-2pubmed: 29374783google scholar: lookup
                    16. Quintero V JC, Paternina T LE, Uribe Y A, Muskus C, Hidalgo M, Gil J, Cienfuegos G AV, Osorio Q L, Rojas A C. Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach. PLoS Negl Trop Dis 2017 Sep;11(9):e0005892.
                      doi: 10.1371/journal.pntd.0005892pubmed: 28922404google scholar: lookup
                    17. Eisawi NM, Hassan DA, Hussien MO, Musa AB, El Hussein ARM. Seroprevalence of spotted fever group (SFG) rickettsiae infection in domestic ruminants in Khartoum State, Sudan. Vet Med Sci 2017 May;3(2):91-98.
                      doi: 10.1002/vms3.59pubmed: 28713577google scholar: lookup
                    18. Costa FB, da Costa AP, Moraes-Filho J, Martins TF, Soares HS, Ramirez DG, Dias RA, Labruna MB. Rickettsia amblyommatis infecting ticks and exposure of domestic dogs to Rickettsia spp. in an Amazon-Cerrado transition region of northeastern Brazil. PLoS One 2017;12(6):e0179163.
                      doi: 10.1371/journal.pone.0179163pubmed: 28594882google scholar: lookup
                    19. Ueno TE, Costa FB, Moraes-Filho J, Agostinho WC, Fernandes WR, Labruna MB. Experimental infection of horses with Rickettsia rickettsii. Parasit Vectors 2016 Sep 13;9(1):499.
                      doi: 10.1186/s13071-016-1784-ypubmed: 27624315google scholar: lookup
                    20. Novakova M, Costa FB, Krause F, Literak I, Labruna MB. Rickettsia vini n. sp. (Rickettsiaceae) infecting the tick Ixodes arboricola (Acari: Ixodidae). Parasit Vectors 2016 Aug 26;9(1):469.
                      doi: 10.1186/s13071-016-1742-8pubmed: 27565956google scholar: lookup
                    21. Souza CE, Camargo LB, Pinter A, Donalisio MR. High Seroprevalence for Rickettsia rickettsii in Equines Suggests Risk of Human Infection in Silent Areas for the Brazilian Spotted Fever. PLoS One 2016;11(4):e0153303.
                      doi: 10.1371/journal.pone.0153303pubmed: 27064788google scholar: lookup
                    22. Lledó L, Domínguez-Peñafiel G, Giménez-Pardo C, Gegúndez I, González R, Saz JV. Molecular and serological study of rickettsial infection in humans, and in wild and farm animals, in the province of Burgos, Spain. Vector Borne Zoonotic Dis 2014 Jun;14(6):383-8.
                      doi: 10.1089/vbz.2013.1513pubmed: 24866558google scholar: lookup
                    23. Argüello AP, Hun L, Rivera P, Taylor L. A fatal urban case of rocky mountain spotted fever presenting an eschar in San Jose, Costa Rica. Am J Trop Med Hyg 2012 Aug;87(2):345-8.
                      doi: 10.4269/ajtmh.2012.12-0153pubmed: 22855769google scholar: lookup
                    24. Pacheco RC, Moraes-Filho J, Marcili A, Richtzenhain LJ, Szabó MP, Catroxo MH, Bouyer DH, Labruna MB. Rickettsia monteiroi sp. nov., infecting the tick Amblyomma incisum in Brazil. Appl Environ Microbiol 2011 Aug;77(15):5207-11.
                      doi: 10.1128/AEM.05166-11pubmed: 21685169google scholar: lookup
                    25. Forshey BM, Stewart A, Morrison AC, Gálvez H, Rocha C, Astete H, Eza D, Chen HW, Chao CC, Montgomery JM, Bentzel DE, Ching WM, Kochel TJ. Epidemiology of spotted fever group and typhus group rickettsial infection in the Amazon basin of Peru. Am J Trop Med Hyg 2010 Apr;82(4):683-90.
                      doi: 10.4269/ajtmh.2010.09-0355pubmed: 20348519google scholar: lookup
                    26. Dantas-Torres F. Canine vector-borne diseases in Brazil. Parasit Vectors 2008 Aug 8;1(1):25.
                      doi: 10.1186/1756-3305-1-25pubmed: 18691408google scholar: lookup
                    27. Tabuchi M, Jilintai, Sakata Y, Miyazaki N, Inokuma H. Serological survey of Rickettsia japonica infection in dogs and cats in Japan. Clin Vaccine Immunol 2007 Nov;14(11):1526-8.
                      doi: 10.1128/CVI.00333-07pubmed: 17913859google scholar: lookup
                    28. Labruna MB, Pacheco RC, Richtzenhain LJ, Szabó MP. Isolation of Rickettsia rhipicephali and Rickettsia bellii from Haemaphysalis juxtakochi ticks in the state of São Paulo, Brazil. Appl Environ Microbiol 2007 Feb;73(3):869-73.
                      doi: 10.1128/AEM.02249-06pubmed: 17142361google scholar: lookup
                    29. Horta MC, Labruna MB, Durigon EL, Schumaker TT. Isolation of Rickettsia felis in the mosquito cell line C6/36. Appl Environ Microbiol 2006 Feb;72(2):1705-7.
                    30. Parola P, Paddock CD, Raoult D. Tick-borne rickettsioses around the world: emerging diseases challenging old concepts. Clin Microbiol Rev 2005 Oct;18(4):719-56.
                      doi: 10.1128/CMR.18.4.719-756.2005pubmed: 16223955google scholar: lookup
                    31. Sangioni LA, Horta MC, Vianna MC, Gennari SM, Soares RM, Galvão MA, Schumaker TT, Ferreira F, Vidotto O, Labruna MB. Rickettsial infection in animals and Brazilian spotted fever endemicity. Emerg Infect Dis 2005 Feb;11(2):265-70.
                      doi: 10.3201/eid1102.040656pubmed: 15752445google scholar: lookup
                    32. França DA, Sampaio ANDCE, Possebon FS, Reis Teixeira WS, Ribeiro BLD, Labruna MB, Costa FB, Sidi-Boumedine K, Pereira JG, Rousset É, Thiéry R, Pereira Dos Santos FC, Colombo S, Megid J, Mioni MSR. Comparison of in-house immunofluorescence assay (IFA) and commercial enzyme-linked immunosorbent assay (ELISA) for Coxiella burnetii infection in cattle. Vet Res Commun 2025 Oct 29;50(1):13.
                      doi: 10.1007/s11259-025-10950-2pubmed: 41160261google scholar: lookup
                    33. Latré de Laté P, Stoll IM, Ferm J, Madesh S, Ferm D, Chauhan D, Choudhury D, Liu H, Yadav A, Ganta S, Kim DY, McGill JL, Ganta RR. Rickettsia rickettsii inactivated whole cell antigen vaccine protects against Rocky Mountain spotted fever independent of the adjuvant used. Infect Immun 2025 Dec 16;93(12):e0041225.
                      doi: 10.1128/iai.00412-25pubmed: 41159782google scholar: lookup
                    34. Freitas AR, de França DA, Kmetiuk LB, Martini R, Delai RR, Pimpão CT, Perotta JH, Roque de Barros-Filho I, Figueiredo FB, Giuffrida R, Santarém VA, Langoni H, Biondo AW. One Health approach to Coxiella burnetii: first serosurvey of owners and dogs living on oceanic islands and mainland seashore areas of Brazil. Front Public Health 2025;13:1643457.
                      doi: 10.3389/fpubh.2025.1643457pubmed: 40900703google scholar: lookup
                    35. Ferreira MFFR, de Campos Binder L, Nogueira RMS, Silva RMME, Ramos CCM, Dall'Agnol LT, Martins TF, Bittencourt RBM, da Silva Krawczak F, Costa-Junior LM, Labruna MB, Lima MIS, Luz HR. High seroprevalence of Rickettsia spp. and molecular detection of Rickettsia amblyommatis in human-biting ticks from the eastern Amazon, Brazil. Parasit Vectors 2025 Aug 4;18(1):330.
                      doi: 10.1186/s13071-025-06944-3pubmed: 40754521google scholar: lookup
                    36. Pádua GT, Tavares MA, de Lima NJ, Paula WVF, Dos Santos GC, Neves LC, Bittencourt RBM, Paludo RLDR, Cardoso ERN, da Silva BBF, Pádua BR, Borsanelli AC, Dantas-Torres F, Polo GP, Krawczak FDS. Spatial Distribution of Equid Exposure to Rickettsia spp. in Goiás State, Midwestern Brazil. Pathogens 2025 May 2;14(5).
                      doi: 10.3390/pathogens14050449pubmed: 40430769google scholar: lookup
                    37. Rahman S, Liu H, Shah M, Almutairi MM, Liaqat I, Tanaka T, Chen CC, Alouffi A, Ali A. Prediction of potential drug targets and key inhibitors (ZINC67974679, ZINC67982856, and ZINC05668040) against Rickettsia felis using integrated computational approaches. Front Vet Sci 2024;11:1507496.
                      doi: 10.3389/fvets.2024.1507496pubmed: 39885844google scholar: lookup
                    38. Neves LC, de Campos Binder L, de Freitas Paula WV, de Lima NJ, Cardoso ERN, Santos RA, Bittencourt RBM, Pádua GT, Dos Santos GC, Tavares MA, de Azevedo Serpa MC, Pinter A, de Almeida Felicio AL, Labruna MB, da Silva Krawczak F. Experimental infection of wild boars (Sus scrofa) with Rickettsia rickettsii and evaluation of the transmission potential to Amblyomma sculptum ticks. Parasit Vectors 2025 Jan 16;18(1):9.
                      doi: 10.1186/s13071-024-06612-ypubmed: 39819468google scholar: lookup
                    39. Albuquerque MP, Horta MC, Melo DRX, Takeda GACG, Arraes-Santos AI, Martins TF, Pinter A. Eco-epidemiological analysis of Rickettsia parkeri in domestic dogs and Amblyomma ovale ticks in the Atlantic rainforest of Northeast Brazil. Rev Bras Parasitol Vet 2024;33(4):e012524.
                      doi: 10.1590/S1984-29612024077pubmed: 39699435google scholar: lookup
                    40. de Lima NJ, Pádua GT, Cardoso ERN, Bittencourt RBM, Tavares MA, Paula WVF, Neves LC, Segovia CD, Dos Santos GC, Serpa MCA, Toledo DC, Pascoal LM, Labruna MB, Biondo AW, Krawczak FDS. Serological and Molecular Survey of Rickettsial Agents in Wild Boars (Sus scrofa) from Midwestern Brazil. Animals (Basel) 2024 Jul 31;14(15).
                      doi: 10.3390/ani14152224pubmed: 39123749google scholar: lookup
                    41. Caixeta BT, Tolesano-Pascoli GV, Mundim FL, Pascoal JO, Rodrigues VDS, Martins MM, Ramos VDN, Torga K, Costa LF, Miranda VC, Benfatti LR, Silva LM, Limongi JE, Szabó MPJ, Yokosawa J. Survey of Rickettsia spp. in ticks (Acari: Ixodidae) infesting opossums (Didelphis albiventris) and capybaras (Hydrochoerus hydrochaeris) from an urban park in southeastern Brazil. Exp Appl Acarol 2024 Apr;92(3):463-477.
                      doi: 10.1007/s10493-023-00885-1pubmed: 38361037google scholar: lookup
                    42. Paludo RLDR, Paula WVF, Neves LC, de Paula LGF, de Lima NJ, da Silva BBF, Pereira BG, Pádua GT, Dantas-Torres F, Labruna MB, Martins TF, Sponchiado J, Sousa-Paula LC, Hannibal W, Krawczak FDS. Rickettsial Infection in Ticks from a National Park in the Cerrado Biome, Midwestern Brazil. Pathogens 2023 Dec 22;13(1).
                      doi: 10.3390/pathogens13010013pubmed: 38251322google scholar: lookup
                    43. Quintero-Vélez JC, Cienfuegos-Gallet AV, Quintero LO, Úsuga AF, Cifuentes S, Solari S, Rodas JD, Diaz FJ, Rojas CA. Epidemiology of Rickettsial Infection in the Municipality of Uramita, Colombia. Am J Trop Med Hyg 2021 Aug 9;105(4):1013-1023.
                      doi: 10.4269/ajtmh.20-0104pubmed: 34370699google scholar: lookup
                    44. Costa SCL, de Souza Freitas J, Carvalho FS, Pereira MJS, Cordeiro MD, da Fonseca AH, Gomes Jusi MM, Machado RZ, Munhoz AD. Frequency and factors associated of potential zoonotic pathogens (Borrelia spp., Rickettsia spp., Leishmania spp., and Anaplasma phagocytophilum) in equids in the state of Bahia, Brazil. Parasit Vectors 2021 May 22;14(1):275.
                      doi: 10.1186/s13071-021-04777-4pubmed: 34022939google scholar: lookup