{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:02:36Z","timestamp":1789534956085,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020648","name":"Universidade Estadual de Santa Cruz","doi-asserted-by":"publisher","award":["073.6762.2024.0031848\u201095"],"award-info":[{"award-number":["073.6762.2024.0031848\u201095"]}],"id":[{"id":"10.13039\/501100020648","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Since 2010, six cases of Atlantic rainforest spotted fever (ARSF) have been confirmed and reported in Brazil, a tick\u2010borne disease caused by\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Rickettsia parkeri<\/jats:italic>\n                      <\/jats:styled-content>\n                      strain Atlantic rainforest and associated with the tick\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Amblyomma ovale<\/jats:italic>\n                      <\/jats:styled-content>\n                      . So far, none of the cases have been associated with death. One of the cases occurred in 2018 in the municipality of Ilh\u00e9us, Bahia state, that is in Atlantic Forest Biome. In this study, we report the first confirmed outbreak of ARSF in Brazil, with three new cases associated with tick bites when entering Atlantic Forest areas in the same municipality, from March 11 to April 4, 2025.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Scab samples from inoculation eschars of three patients presenting post\u2010tick\u2010bite symptoms were collected for molecular analysis targeting a fragment of the ompA gene of\n                      <jats:italic>R<\/jats:italic>\n                      <jats:italic>. parkeri<\/jats:italic>\n                      , followed by DNA sequencing. Paired serum samples (acute and convalescent phases) were evaluated by immunofluorescence assay (IFA) against\n                      <jats:italic>R. parkeri<\/jats:italic>\n                      antigens. Additionally, small mammals were captured using Sherman and Tomahawk traps during the same period in the exposure sites to evaluate tick infestation dynamics and species.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients developed symptoms 7\u201310\u2009days after the bite, including inoculation eschar with progressive enlargement, exanthema, regional lymphadenopathy, fever, myalgia, and prostration; all responded to doxycycline treatment. Molecular analysis confirmed the presence of\n                      <jats:italic>R. parkeri<\/jats:italic>\n                      strain Atlantic rainforest DNA in all scab samples. Seroconversion (IgG) to\n                      <jats:italic>R. parkeri<\/jats:italic>\n                      was demonstrated in two patients. A total of 10 immature\n                      <jats:italic>A. ovale<\/jats:italic>\n                      ticks (larvae and nymphs) were collected parasitizing the wild cricetid rodents\u2009\n                      <jats:italic>Hylaeamys seuanezi<\/jats:italic>\n                      \u2009 (three individuals) and \u2009\n                      <jats:italic>Thaptomys nigrita<\/jats:italic>\n                      \u2009(one individual) in the outbreak area.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This report demonstrates three new confirmed cases and the first reported cluster of ARSF in Brazil, confirmed by laboratorial criteria, including molecular analyses, demonstrating the potential of the southern region of Bahia for transmission of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>R.\u2009parkeri<\/jats:italic>\n                      <\/jats:styled-content>\n                      , thus making it an endemic area for the disease.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/zph.70093","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:12:31Z","timestamp":1789531951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short Report: First Outbreak of Atlantic Rainforest Spotted Fever in North\u2010Eastern of Brazil\u2014Clinical Features and Eco\u2010Epidemiological Investigation"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1548-2152","authenticated-orcid":false,"given":"Gabriel Nunes","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Ci\u00eancia Animal\u2014PPGCA UESC (Universidade Estadual de Santa Cruz)  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