{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:06:04Z","timestamp":1760234764612,"version":"build-2065373602"},"reference-count":76,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T00:00:00Z","timestamp":1623456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Marie Bashir Instirute","award":["Marie Bashir Institute 2017 Zoonoses Node Seed Funding"],"award-info":[{"award-number":["Marie Bashir Institute 2017 Zoonoses Node Seed Funding"]}]},{"name":"National Health and Medical Research Council","award":["APP1049558"],"award-info":[{"award-number":["APP1049558"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Rickettsioses are arthropod-borne zoonotic diseases, several of which occur in Australia. This study aimed to assess the exposure levels and risk factors for Rickettsia spp. among Australian wildlife rehabilitators (AWRs) using serology, PCR and a questionnaire. Antibody titres against Spotted Fever Group (SFG), Typhus Group (TG) and Scrub Typhus Group (STG) antigens were determined using an immunofluorescence assay. PCR targeting the gltA gene was performed on DNA extracts from whole blood and serum. Logistic regression was used to identify risk factors associated with seropositivity. Of the 27 (22.1%; 27\/122) seropositive participants all were seropositive for SFG, with 5\/27 (4.1%) also positive for TG. Of the 27 positive sera, 14.8% (4\/27) were further classified as exposure to R. australis, 3.7% (1\/27) to R. honei, 3.7% (1\/27) to R. felis and 77.8% (21\/27) were classified as \u2018indeterminate\u2019\u2014most of which (85.7%; 18\/21) were indeterminate R. australis\/R. honei exposures. Rickettsia DNA was not detected in whole blood or serum. Rehabilitators were more likely to be seropositive if more than one household member rehabilitated wildlife, were older than 50 years or had occupational animal contact. These findings suggest that AWRs are at increased risk of contracting Rickettsia-related illnesses, however the source of the increased seropositivity remains unclear.<\/jats:p>","DOI":"10.3390\/pathogens10060745","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T22:25:46Z","timestamp":1623709546000},"page":"745","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Serological Evidence of Exposure to Spotted Fever Group and Typhus Group Rickettsiae in Australian Wildlife Rehabilitators"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8320-5244","authenticated-orcid":false,"given":"Karen O.","family":"Mathews","sequence":"first","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Phalen","sequence":"additional","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0003-6930","authenticated-orcid":false,"given":"Jacqueline M.","family":"Norris","sequence":"additional","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Stenos","sequence":"additional","affiliation":[{"name":"Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-2599","authenticated-orcid":false,"given":"Jenny-Ann","family":"Toribio","sequence":"additional","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Wood","sequence":"additional","affiliation":[{"name":"Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia"},{"name":"National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Graves","sequence":"additional","affiliation":[{"name":"Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-1606","authenticated-orcid":false,"given":"Paul A.","family":"Sheehy","sequence":"additional","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-2162","authenticated-orcid":false,"given":"Katrina L.","family":"Bosward","sequence":"additional","affiliation":[{"name":"Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"unstructured":"Baron, S. (1996). Rickettsiae. Medical Microbiology, University of Texas.","key":"ref_1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.idc.2018.10.010","article-title":"The Rickettsioses: A practical update","volume":"33","author":"Blanton","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"537","DOI":"10.2217\/fmb.14.141","article-title":"Strategies for detecting rickettsiae and diagnosing rickettsial diseases","volume":"10","author":"Mullins","year":"2015","journal-title":"Futur. Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3201\/eid0402.980205","article-title":"Rickettsial pathogens and their arthropod vectors","volume":"4","author":"Azad","year":"1998","journal-title":"Emerging Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4404","DOI":"10.1128\/JCM.01526-10","article-title":"Isolation of a Novel Orientia Species (O. chutosp. nov.) from a Patient Infected in Dubai","volume":"48","author":"Izzard","year":"2010","journal-title":"J. Clin. Microbiol."},{"unstructured":"NSW Department of Health (2019, February 04). Typhus (Epidemic, Murine and Other Rickettsial Diseases) Fact Sheet, Available online: https:\/\/www.health.nsw.gov.au\/Infectious\/factsheets\/Pages\/Typhus.aspx#.","key":"ref_6"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.3201\/eid1311.070099","article-title":"Severe Spotted Fever Group Rickettsiosis, Australia","volume":"13","author":"McBride","year":"2007","journal-title":"Emerg. Infect. Dis."},{"doi-asserted-by":"crossref","unstructured":"Xu, G., Walker, D.H., Jupiter, D., Melby, P.C., and Arcari, C.M. (2017). A review of the global epidemiology of scrub typhus. PLoS Negl. Trop. Dis., 11.","key":"ref_8","DOI":"10.1371\/journal.pntd.0006062"},{"doi-asserted-by":"crossref","unstructured":"Stewart, A., Smith, S., Binotto, E., McBride, W.J.H., and Hanson, J. (2019). The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management. PLoS Negl. Trop. Dis., 13.","key":"ref_9","DOI":"10.1371\/journal.pntd.0007583"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1093\/infdis\/162.3.779","article-title":"Fatal queensland tick typhus","volume":"162","author":"Sexton","year":"1990","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6502a1","article-title":"Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis","volume":"65","author":"Biggs","year":"2016","journal-title":"MMWR. Recomm. Rep."},{"unstructured":"National Notifiable Diseases Surveillance System (2021, March 15). Disease notification Rates, Australia, 1991 to 2020 and Year-to-Date Notifications for 2021. Commun. Dis. Intell, Available online: http:\/\/www9.health.gov.au\/cda\/source\/rpt_3.cfm.","key":"ref_12"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1749-6632.2009.04530.x","article-title":"Rickettsioses in Australia","volume":"1166","author":"Graves","year":"2009","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"480","DOI":"10.3201\/eid0904.020509","article-title":"Scrub Typhus in the Torres Strait Islands of North Queensland, Australia","volume":"9","author":"Faa","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","first-page":"267","article-title":"Scrub typhus in the Northern Territory: Exceeding the boundaries of Litchfield National Park","volume":"28","author":"Whelan","year":"2004","journal-title":"Commun. Dis. Intell. Q. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"786","DOI":"10.4269\/ajtmh.1999.60.786","article-title":"Rickettsia serosurvey in Kimberley, Western Australia","volume":"60","author":"Graves","year":"1999","journal-title":"Am. J. Trop. Med. Hyg."},{"doi-asserted-by":"crossref","unstructured":"Mullen, G.R., and Durden, L.A. (2019). Mites (Acari). Medical and Veterinary Entomology, Academic Press. [3rd ed.].","key":"ref_17","DOI":"10.1016\/B978-0-12-814043-7.00026-1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"320","DOI":"10.5694\/mja17.00090","article-title":"Tick-borne infectious diseases in Australia","volume":"206","author":"Graves","year":"2017","journal-title":"Med. J. Aust."},{"doi-asserted-by":"crossref","unstructured":"Raby, E., Pearn, T., Marangou, A.G., Merritt, A.J., Murray, R.J., Dyer, J.R., and Graves, S.R. (2016). New Foci of Spotted Fever Group Rickettsiae Including Rickettsia honei in Western Australia. Trop. Med. Infect. Dis., 1.","key":"ref_19","DOI":"10.3390\/tropicalmed1010005"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1080\/00313020500099247","article-title":"Not only \u2019Flinders Island\u2019 spotted fever","volume":"37","author":"Unsworth","year":"2005","journal-title":"Pathology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11646\/zootaxa.3816.1.1","article-title":"Ticks of Australia. The species that infest domestic animals and humans","volume":"3816","author":"Barker","year":"2014","journal-title":"Zootaxa"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5694\/j.1326-5377.2011.tb04145.x","article-title":"First probable Australian cases of human infection with Rickettsia felis (cat-flea typhus)","volume":"194","author":"Williams","year":"2011","journal-title":"Med. J. Aust."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1089\/vbz.2010.0270","article-title":"Molecular Evidence Supports the Role of Dogs as Potential Reservoirs for Rickettsia felis","volume":"11","author":"Hii","year":"2011","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4151","DOI":"10.1038\/s41598-020-61122-y","article-title":"Domestic dogs are mammalian reservoirs for the emerging zoonosis flea-borne spotted fever, caused by Rickettsia felis","volume":"10","author":"Hii","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5694\/j.1326-5377.1999.tb126896.x","article-title":"Murlne typhus in metropolitan Perth","volume":"170","author":"Beaman","year":"1999","journal-title":"Med. J. Aust."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"650","DOI":"10.5694\/j.1326-5377.1992.tb121464.x","article-title":"A case of murine typhus in Queensland","volume":"156","author":"Graves","year":"1992","journal-title":"Med. J. Aust."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"482","DOI":"10.5694\/j.1326-5377.2004.tb06032.x","article-title":"Murine typhus: The first reported case from Victoria","volume":"180","author":"Jones","year":"2004","journal-title":"Med. J. Aust."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1128\/CMR.00032-13","article-title":"Update on Tick-Borne Rickettsioses around the World: A Geographic Approach","volume":"26","author":"Parola","year":"2013","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"566","DOI":"10.3201\/eid1304.050087","article-title":"Flinders Island Spotted Fever Rickettsioses Caused by \u201cmarmionii\u201d Strain of Rickettsia honei, Eastern Australia","volume":"13","author":"Unsworth","year":"2007","journal-title":"Emerg. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/qjmed\/hcm149","article-title":"Markers of exposure to spotted fever rickettsiae in patients with chronic illness, including fatigue, in two Australian populations","volume":"101","author":"Unsworth","year":"2008","journal-title":"Q. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/j.1440-1584.2006.00831.x","article-title":"Potentially pathogenic spotted fever group rickettsiae present in Western Australia","volume":"14","author":"Owen","year":"2006","journal-title":"Aust. J. Rural. Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1093\/jmedent\/45.4.745","article-title":"Detection of a spotted fever group Rickettsia in the tick Ixodes tasmani collected from koalas in Port Macquarie, Australia","volume":"45","author":"Vilcins","year":"2008","journal-title":"J. Med. Entomol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.3201\/eid1510.090799","article-title":"Novel Rickettsia in Ticks, Tasmania, Australia","volume":"15","author":"Izzard","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s13071-017-2075-y","article-title":"Serological evidence of exposure to Rickettsia felis and Rickettsia typhi in Australian veterinarians","volume":"10","author":"Teoh","year":"2017","journal-title":"Parasites Vectors"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"584","DOI":"10.4269\/ajtmh.14-0102","article-title":"Seroepidemiological Study of Outdoor Recreationists\u2019 Exposure to Spotted Fever Group Rickettsia in Western Australia","volume":"91","author":"Abdad","year":"2014","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.onehlt.2020.100197","article-title":"Coxiella burnetii seroprevalence and Q fever in Australian wildlife rehabilitators","volume":"12","author":"Mathews","year":"2021","journal-title":"One Health"},{"unstructured":"National Rural Health Alliance (2020, February 17). The Little Book of Rural Health Numbers. Available online: https:\/\/www.ruralhealth.org.au\/book\/demography.","key":"ref_37"},{"unstructured":"Australian Veterinary Association (2019, July 31). Guidelines for Veterinary Personal Biosecurity. Available online: https:\/\/www.ava.com.au\/library-resources\/other-resources\/veterinary-personal-biosecurity\/.","key":"ref_38"},{"unstructured":"Wildlife Health Australia (2019, July 31). National Wildlife Biosecurity Guidelines. Version 1.0. Available online: https:\/\/www.wildlifehealthaustralia.com.au\/Portals\/0\/Documents\/ProgramProjects\/National_Wildlife_Biosecurity_Guidelines.PDF.","key":"ref_39"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5694\/j.1326-5377.1991.tb120994.x","article-title":"Flinders Island spotted fever: A newly recognised endemic focus of tick typhus in Bass Strait: Part 2. Serological investigations","volume":"154","author":"Graves","year":"1991","journal-title":"Med. J. Aust."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10493-009-9260-4","article-title":"Molecular detection of Rickettsia, Coxiella and Rickettsiella DNA in three native Australian tick species","volume":"49","author":"Vilcins","year":"2009","journal-title":"Exp. Appl. Acarol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"231","DOI":"10.5694\/j.1326-5377.2005.tb06673.x","article-title":"A new focus of Rickettsia honei spotted fever in South Australia","volume":"182","author":"Dyer","year":"2005","journal-title":"Med. J. Aust."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"121","DOI":"10.5694\/j.1326-5377.1991.tb120998.x","article-title":"Spotted fever in East Gippsland, Victoria: A previously unrecognised focus of rickettsial infection","volume":"154","author":"Dwyer","year":"1991","journal-title":"Med. J. Aust."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1751-0813.2010.00569.x","article-title":"Lappin Prevalence of Bartonella species, Rickettsia felis, haemoplasmas and the Ehrlichia group in the blood of cats and fleas in eastern Australia","volume":"88","author":"Barrs","year":"2010","journal-title":"Aust. Vet. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"841","DOI":"10.3201\/eid1205.051458","article-title":"Rickettsia felis in fleas, Western Australia","volume":"12","author":"Schloderer","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/QCO.0000000000000298","article-title":"State of the art of diagnosis of rickettsial diseases: The use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus","volume":"29","author":"Paris","year":"2016","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.4269\/ajtmh.2005.73.1083","article-title":"A Highly Sensitive and Specific Real-Time Pcr Assay for the Detection of Spotted Fever and Typhus Group Rickettsiae","volume":"73","author":"Stenos","year":"2005","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1128\/CMR.18.4.719-756.2005","article-title":"Tick-Borne Rickettsioses around the World: Emerging Diseases Challenging Old Concepts","volume":"18","author":"Parola","year":"2005","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1001\/archinte.1983.00350060073012","article-title":"Correlation of Rickettsial Titers, Circulating Endotoxin, and Clinical Features in Rocky Mountain Spotted Fever","volume":"143","author":"Kaplowitz","year":"1983","journal-title":"Arch. Intern. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1038\/sj.bjc.6601609","article-title":"Quantitation of circulating DNA in the serum of breast cancer patients by real-time PCR","volume":"90","author":"Gal","year":"2004","journal-title":"Br. J. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.cmi.2015.12.019","article-title":"Estimation of Rickettsia rickettsii copy number in the blood of patients with Rocky Mountain spotted fever suggests cyclic diurnal trends in bacteraemia","volume":"22","author":"Kato","year":"2016","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/1753-6405.12918","article-title":"New and old hotspots for rickettsial spotted fever acquired in Tasmania, 2012\u20132017","volume":"43","author":"Willis","year":"2019","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/BF00140130","article-title":"Ecological relationships between ticks and rickettsiae","volume":"5","year":"1989","journal-title":"Eur. J. Epidemiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5694\/j.1326-5377.1996.tb124812.x","article-title":"A cluster of murine typhus cases in Western Australia","volume":"165","author":"Kelly","year":"1996","journal-title":"Med. J. Aust."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1128\/iai.25.2.580-582.1979","article-title":"Exposure of guinea pigs to Rickettsia rickettsii by aerosol, nasal, conjunctival, gastric, and subcutaneous routes and protection afforded by an experimental vaccine","volume":"25","author":"Kenyon","year":"1979","journal-title":"Infect. Immun."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1128\/br.30.3.636-645.1966","article-title":"Aerosol infection of monkeys with Rickettsia rickettsii","volume":"30","author":"Saslaw","year":"1966","journal-title":"Bacteriol. Rev."},{"key":"ref_57","first-page":"486","article-title":"The pathogenesis of Rocky Mountain spotted fever in monkeys, infected by inhalation","volume":"84","author":"Wolf","year":"1967","journal-title":"Arch. Pathol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1001\/jama.1970.03170120056014","article-title":"Rocky Mountain Spotted Fever: Laboratory infection in a vaccinated individual","volume":"211","author":"Calia","year":"1970","journal-title":"JAMA"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1056\/NEJM196710192771603","article-title":"Rocky Mountain Spotted Fever Acquired in a Laboratory","volume":"277","author":"Johnson","year":"1967","journal-title":"N. Engl. J. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1056\/NEJM197710202971604","article-title":"Laboratory-Acquired Rocky Mountain Spotted Fever: The hazard of aerosol transmission","volume":"297","author":"Oster","year":"1977","journal-title":"N. Engl. J. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"731","DOI":"10.5694\/j.1326-5377.1954.tb66921.x","article-title":"Murine typhus in Western Australia","volume":"2","author":"Saint","year":"1954","journal-title":"Med. J. Aust."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1128\/jcm.35.11.2715-2727.1997","article-title":"Laboratory diagnosis of rickettsioses: Current approaches to diagnosis of old and new rickettsial diseases","volume":"35","author":"Raoult","year":"1997","journal-title":"J.Clin. Microbio."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1099\/00222615-29-3-199","article-title":"Cross-reaction of immune sera from patients with rickettsial diseases","volume":"29","author":"Hechemy","year":"1989","journal-title":"J. Med. Microbiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1128\/CDLI.7.4.612-616.2000","article-title":"Serological Differentiation of Murine Typhus and Epidemic Typhus Using Cross-Adsorption and Western Blotting","volume":"7","author":"Rydkina","year":"2000","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.onehlt.2016.06.001","article-title":"Evidence of exposure to Rickettsia felis in Australian patients","volume":"2","author":"Teoh","year":"2016","journal-title":"One Health"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.4269\/ajtmh.15-0372","article-title":"Human Infections by Multiple Spotted Fever Group Rickettsiae in Tennessee","volume":"94","author":"Delisle","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1128\/jcm.30.11.2896-2902.1992","article-title":"Characterization and comparison of Australian human spotted fever group rickettsiae","volume":"30","author":"Baird","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1001\/jama.1909.25420310039002","article-title":"A micro-organism which apparently has a specific relationship to Rocky Mountain spotted fever: A preliminary report","volume":"52","author":"Ricketts","year":"1909","journal-title":"J. Am. Med. Assoc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1099\/ijsem.0.001865","article-title":"Rickettsia gravesii sp. nov.: A novel spotted fever group rickettsia in Western Australian Amblyomma triguttatum triguttatum ticks","volume":"67","author":"Abdad","year":"2017","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1099\/00207713-48-4-1399","article-title":"Rickettsia honei sp. nov., the aetiological agent of Flinders Island spotted fever in Australia","volume":"48","author":"Stenos","year":"1998","journal-title":"Int. J. Syst. Bacteriol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J. Biomed. Inform."},{"unstructured":"Dhand, N.K., and Khatkar, M.S. (2019, May 07). Statulator: An Online Statistical Calculator. Sample Size Calculator for Estimating a Single Propor-tion. Available online: http:\/\/statulator.com\/SampleSize\/ss1P.html.","key":"ref_73"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/zph.12658","article-title":"Coxiella burnetii seroprevalence in unvaccinated veterinary workers in Australia: Evidence to support Q fever vaccination","volume":"67","author":"Sellens","year":"2020","journal-title":"Zoonoses Public Health"},{"doi-asserted-by":"crossref","unstructured":"Mediannikov, O., Fenollar, F., Socolovschi, C., Diatta, G., Bassene, H., Molez, J.-F., Sokhna, C., Trape, J.-F., and Raoult, D. (2010). Coxiella burnetii in Humans and Ticks in Rural Senegal. PLoS Negl. Trop. Dis., 4.","key":"ref_75","DOI":"10.1371\/journal.pntd.0000654"},{"unstructured":"R Core Team (2018, December 18). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. Available online: http:\/\/www.R-project.org\/.","key":"ref_76"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/6\/745\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:13:47Z","timestamp":1760163227000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/6\/745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,12]]},"references-count":76,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["pathogens10060745"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10060745","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2021,6,12]]}}}