{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:13:16Z","timestamp":1767917596651,"version":"3.49.0"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Mediterranean spotted fever (MSF) is an emerging tick-borne disease caused by Rickettsia conorii subsp. conorii, primarily prevalent in Mediterranean and Southern Europe. We aimed to evaluate MSF seroprevalence and risk factors in non-endemic rural areas of Romania. Methods: We conducted a serosurvey in five counties not under MSF surveillance by testing 459 serum samples from adult volunteers for specific IgG antibodies using ELISA. Participants answered a questionnaire regarding demographics and MSF risk factors. Results: The median age of the participants was 60 years and 329 (71.7%) were female. Overall, 64 (13.9%) samples tested positive for IgG anti-R. conorii, with rates ranging from 7.1% in Sibiu to 22.4% in Hunedoara. The median age of the positive individuals was 68 years, with a significantly higher seropositivity rate of 54.7% among those over 65 years (p = 0.01). Among those positive, 53 (82.8%) owned different household animals; 24 (37.5%) had daily contact with dogs, and 27 (42.2%) with livestock; 17 (26.6%) noted tick infestations of animals, and 23 (35.9%) reported tick bites. Conclusions: This study revealed an important seroprevalence of MSF in Romanian areas considered non-endemic, indicating an expansion of its geographical range, probably due to climate change, and emphasizing the importance of enhanced surveillance and diagnostic capabilities nationwide.<\/jats:p>","DOI":"10.3390\/pathogens13090783","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T07:59:46Z","timestamp":1726041586000},"page":"783","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Identifying New Areas of Endemicity and Risk Factors for Rickettsia conorii subsp. conorii Infection: Serosurvey in Rural Areas of Romania"],"prefix":"10.3390","volume":"13","author":[{"given":"Cristina Alexandra","family":"Cheran","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea Madalina","family":"Panciu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cProf. Dr. Matei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia Doina","family":"Riciu","sequence":"additional","affiliation":[{"name":"\u201cProf. Dr. Matei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8095-4650","authenticated-orcid":false,"given":"Iulia Maria","family":"Nedelcu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cProf. Dr. Matei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana Gabriela","family":"Iacob","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, Bucharest Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-1699","authenticated-orcid":false,"given":"Adriana","family":"Hristea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cProf. Dr. Matei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.micinf.2015.09.009","article-title":"Rickettsioses in Europe","volume":"17","author":"Portillo","year":"2015","journal-title":"Microbes Infect."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.mimet.2015.10.009","article-title":"Tick-borne rickettsiales: Molecular tools for the study of an emergent group of pathogens","volume":"119","author":"Guillemi","year":"2015","journal-title":"J. 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