{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:54:45Z","timestamp":1777877685245,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T00:00:00Z","timestamp":1580428800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Rickettsia parkeri<\/jats:italic>\n                    rickettsiosis is an emerging, tick-borne disease in the United States (US), transmitted by the bite of\n                    <jats:italic toggle=\"yes\">Amblyomma maculatum<\/jats:italic>\n                    group ticks. Clinical manifestations include fever, headache, myalgia, maculopapular rash, and a characteristic eschar that forms at the site of the tick bite. Arizona's index case of\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    rickettsiosis was reported in 2014. Seven additional confirmed and probable cases were identified during 2016\u20132017 through routine investigation of electronic laboratory reports and by self-reporting to public health authorities. Serum samples were evaluated for immunoglobulin G antibodies reactive with antigens of\n                    <jats:italic toggle=\"yes\">Rickettsia rickettsii<\/jats:italic>\n                    (the agent of Rocky Mountain spotted fever [RMSF]) and\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    using indirect immunofluorescence antibody tests. Eschar swab specimens were evaluated using\n                    <jats:italic toggle=\"yes\">Rickettsia<\/jats:italic>\n                    genus-specific and\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    -specific real-time PCR assays. Patients (six male, one female) ranged in age from 29 to 69 years (median of 41 years), and became ill between July 2016 and September 2017. Fever (6\/7), myalgia (5\/7), and arthralgia (5\/7) were most commonly reported and 5\/7 patients had a documented eschar. All patients reported a tick bite acquired in southern Arizona within 2\u20138 days before illness onset. Four patients worked as U.S. Border Patrol agents. Antibodies reactive to\n                    <jats:italic toggle=\"yes\">R. rickettsii<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    , or to both antigens were detected in all patients. Seroconversions between acute and convalescent-phase samples were identified for two patients and DNA of\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    was identified in eschar swab samples from two patients.\n                    <jats:italic toggle=\"yes\">R. parkeri<\/jats:italic>\n                    rickettsiosis is endemic to a region of the southwestern United States and presents an occupational risk that could be lessened by prevention messaging to Border Patrol agents. RMSF, a closely related and more severe spotted fever rickettsiosis, is also endemic to Arizona. Public health agencies can assist clinicians in distinguishing these two infections clinically through education and accessing species-specific diagnostic assays that can improve surveillance efforts for both diseases.\n                  <\/jats:p>","DOI":"10.1089\/vbz.2019.2491","type":"journal-article","created":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T11:33:53Z","timestamp":1571744033000},"page":"82-87","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Expanding Recognition of\n                    <i>Rickettsia parkeri<\/i>\n                    Rickettsiosis in Southern Arizona, 2016\u20132017"],"prefix":"10.1177","volume":"20","author":[{"given":"Hayley D.","family":"Yaglom","sequence":"first","affiliation":[{"name":"Arizona Department of Health Services, Office of Infectious Disease Services, Phoenix, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Casal","sequence":"additional","affiliation":[{"name":"Arizona Department of Health Services, Office of Border Health, Tucson, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Carson","sequence":"additional","affiliation":[{"name":"Pima County Health Department, Tucson, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine L.","family":"O'Grady","sequence":"additional","affiliation":[{"name":"Pima County Health Department, Tucson, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Santa Cruz County Health Department, Nogales, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Joseph","family":"Singleton","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida","family":"Chung","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Lodge","sequence":"additional","affiliation":[{"name":"Copper Queen Medical Associates, Douglas, Arizona."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Paddock","sequence":"additional","affiliation":[{"name":"Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,1,31]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjx138"},{"key":"e_1_3_4_3_1","first-page":"1","article-title":"Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis\u2014United States","volume":"65","author":"Biggs HM","year":"2016","unstructured":"Biggs HM, , Barton-Behravesh C, , Bradley KK, , Dahlgren FS, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis\u2014United States. MMWR, 2016; 65:1\u201344.","journal-title":"MMWR"},{"key":"e_1_3_4_4_1","first-page":"641","article-title":"The expanding spectrum of eschar-associated rickettsiosis in the United States","volume":"126","author":"Cragun WC","year":"2010","unstructured":"Cragun WC, , Bartlett BL, , Ellis MW, , Hoover AZ, et al. The expanding spectrum of eschar-associated rickettsiosis in the United States. Arch Dermatol, 2010; 126:641\u2013648.","journal-title":"Arch Dermatol"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050043"},{"key":"e_1_3_4_6_1","first-page":"216","article-title":"Gulf Coast tick rash illness in Mississippi caused by Rickettsia parkeri","author":"Ekenna O","year":"2014","unstructured":"Ekenna O, , Paddock CD, , Goddard J. Gulf Coast tick rash illness in Mississippi caused by Rickettsia parkeri. J Mississippi Med Assoc, 2014; 216\u2013219.","journal-title":"J Mississippi Med Assoc"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2205.151824"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2011.0614"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01723-12"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-018-1120-x"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-018-3186-9"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jmedent\/47.4.536"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1905.120622"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/381894"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/592254"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tju022"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.42.7.1537"},{"key":"e_1_3_4_18_1","first-page":"718","article-title":"Rickettsia parkeri rickettsiosis\u2014Georgia, 2012\u20132014","volume":"65","author":"Straily A","year":"2016","unstructured":"Straily A, , Feldpausch A, , Ulbrich C, , Schell K, et al. Rickettsia parkeri rickettsiosis\u2014Georgia, 2012\u20132014. MMWR, 2016; 65:718\u2013719.","journal-title":"MMWR"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix363"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1302.061295"}],"container-title":["Vector-Borne and Zoonotic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/vbz.2019.2491","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/vbz.2019.2491","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/vbz.2019.2491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:59:03Z","timestamp":1777589943000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/vbz.2019.2491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,31]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1089\/vbz.2019.2491"],"URL":"https:\/\/doi.org\/10.1089\/vbz.2019.2491","relation":{},"ISSN":["1530-3667","1557-7759"],"issn-type":[{"value":"1530-3667","type":"print"},{"value":"1557-7759","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,31]]}}}