{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T20:31:42Z","timestamp":1793737902279,"version":"4.6.1"},"reference-count":143,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Mediterranean spotted fever (MSF) is an emerging tick-borne rickettsiosis of the spotted fever group (SFG), endemic in the Mediterranean basin. By virtue of technological innovations in molecular genetics, it has been determined that the causative agent of MSF is Rickettsia conorii subspecies conorii. The arthropod vector of this bacterium is the brown dog tick Rhipicephalus sanguineus. The true nature of the reservoir of R. conorii conorii has not been completely deciphered yet, although many authors theorize that the canine population, other mammals, and the ticks themselves could potentially contribute as reservoirs. Typical symptoms of MSF include fever, maculopapular rash, and a characteristic eschar (\u201ctache noire\u201d). Atypical clinical features and severe multi-organ complications may also be present. All of these manifestations arise from the disseminated infection of the endothelium by R. conorii conorii. Several methods exist for the diagnosis of MSF. Serological tests are widely used and molecular techniques have become increasingly available. Doxycycline remains the treatment of choice, while preventive measures are focused on modification of human behavior and vector control strategies. The purpose of this review is to summarize the current knowledge on the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of MSF.<\/jats:p>","DOI":"10.3390\/tropicalmed6040172","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T23:08:31Z","timestamp":1632784111000},"page":"172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Mediterranean Spotted Fever: Current Knowledge and Recent Advances"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6981-8535","authenticated-orcid":false,"given":"Nikolaos","family":"Spernovasilis","sequence":"first","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioulia","family":"Markaki","sequence":"additional","affiliation":[{"name":"\u201cTrifyllio\u201d General Hospital of Kythira, 80200 Kythira, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michail","family":"Papadakis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Mazonakis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despo","family":"Ierodiakonou","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2417, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.3201\/eid1409.071133","article-title":"Questions on Mediterranean spotted fever a century after its discovery","volume":"14","author":"Rovery","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_2","unstructured":"Farrar, J., Hotez, P.J., Junghanss, T., Kang, G., Lalloo, D., and White, N.J. (2014). Tropical rickettsial infections. Manson\u2019s Tropical Diseases, Elsevier Saunders."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.tmaid.2014.08.006","article-title":"Rickettsioses and Q fever in travelers (2004\u20132013)","volume":"12","author":"Delord","year":"2014","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ijid.2003.06.004","article-title":"Tick-borne rickettsioses in international travellers","volume":"8","author":"Jensenius","year":"2004","journal-title":"Int. J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1086\/319347","article-title":"Ticks and tickborne bacterial diseases in humans: An emerging infectious threat","volume":"32","author":"Parola","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1128\/CMR.10.4.694","article-title":"Rickettsioses as paradigms of new or emerging infectious diseases","volume":"10","author":"Raoult","year":"1997","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Weinert, L.A., Werren, J.H., Aebi, A., Stone, G.N., and Jiggins, F.M. (2009). Evolution and diversity of Rickettsia bacteria. BMC Biol., 7.","DOI":"10.1186\/1741-7007-7-6"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.2217\/fmb.13.102","article-title":"Recent molecular insights into rickettsial pathogenesis and immunity","volume":"8","author":"Sahni","year":"2013","journal-title":"Future Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Klein, D., Beth-Din, A., Cohen, R., Lazar, S., Glinert, I., Zayyad, H., and Atiya-Nasagi, Y. (2019). New spotted fever group rickettsia isolate, identified by sequence analysis of conserved genomic regions. Pathogens, 9.","DOI":"10.3390\/pathogens9010011"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1126\/science.1061471","article-title":"Mechanisms of evolution in Rickettsia conorii and R. prowazekii","volume":"293","author":"Ogata","year":"2001","journal-title":"Science"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zhu, Y., Fournier, P.E., Eremeeva, M., and Raoult, D. (2005). Proposal to create subspecies of Rickettsia conorii based on multi-locus sequence typing and an emended description of Rickettsia conorii. BMC Microbiol., 5.","DOI":"10.1186\/1471-2180-5-11"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e12830","DOI":"10.1111\/pim.12830","article-title":"Recent advances in understanding tick and rickettsiae interactions","volume":"43","author":"Karim","year":"2021","journal-title":"Parasite Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/nrmicro1866","article-title":"Emerging and re-emerging rickettsioses: Endothelial cell infection and early disease events","volume":"6","author":"Walker","year":"2008","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1749-6632.2009.04518.x","article-title":"Deciphering the relationships between Rickettsia conorii conorii and Rhipicephalus sanguineus in the ecology and epidemiology of Mediterranean spotted fever","volume":"1166","author":"Parola","year":"2009","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Socolovschi, C., Gaudart, J., Bitam, I., Huynh, T.P., Raoult, D., and Parola, P. (2012). Why are there so few Rickettsia conorii conorii-infected Rhipicephalus sanguineus ticks in the wild?. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001697"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4269\/ajtmh.1993.48.249","article-title":"Mediterranean spotted fever in Marseille, France: Correlation between prevalence of hospitalized patients, seroepidemiology, and prevalence of infected ticks in three different areas","volume":"48","author":"Raoult","year":"1993","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1196\/annals.1374.063","article-title":"Spotted fever group rickettsiae in ticks feeding on humans in northwestern Spain: Is Rickettsia conorii vanishing?","volume":"1078","year":"2006","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00436-008-0938-z","article-title":"Spotted fever group Rickettsia in brown dog ticks Rhipicephalus sanguineus in southwestern Spain","volume":"103","author":"Marquez","year":"2008","journal-title":"Parasitol. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1023\/A:1007479909654","article-title":"Prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs from and endemic area of mediterranean spotted fever in Catalonia, Spain","volume":"14","year":"1998","journal-title":"Eur. J. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ttbdis.2011.03.001","article-title":"Detection of Rickettsia conorii strains in Portuguese dogs (Canis familiaris)","volume":"2","author":"Alexandre","year":"2011","journal-title":"Ticks Tick-Borne Dis."},{"key":"ref_21","first-page":"322","article-title":"Experimental infection of dogs with a Zimbabwean strain of Rickettsia conorii","volume":"95","author":"Kelly","year":"1992","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_22","first-page":"143","article-title":"Repercussions of myxomatosis on Mediterranean boutonneuse exanthematic fever","volume":"35","year":"1966","journal-title":"Bull. World Health Organ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/j.1749-6632.2003.tb07378.x","article-title":"Mediterranean spotted fever in Portugal: Risk factors for fatal outcome in 105 hospitalized patients","volume":"990","author":"Nobrega","year":"2003","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"174","DOI":"10.3201\/eid1201.050850","article-title":"Rickettsia massiliae human isolation","volume":"12","author":"Vitale","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijid.2017.04.003","article-title":"Israeli Spotted Fever in Sicily. Description of two cases and minireview","volume":"61","author":"Colomba","year":"2017","journal-title":"Int. J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Guccione, C., Colomba, C., Tolomeo, M., Trizzino, M., Iaria, C., and Cascio, A. (2021). Rickettsiales in Italy. Pathogens, 10.","DOI":"10.3390\/pathogens10020181"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Pascucci, I., Di Domenico, M., Curini, V., Cocco, A., Averaimo, D., D\u2019Alterio, N., and Camm\u00e0, C. (2019). Diversity of Rickettsia in ticks collected in Abruzzi and Molise regions (central Italy). Microorganisms, 7.","DOI":"10.3390\/microorganisms7120696"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/BF00151708","article-title":"Relationships between the Rhipicephalus sanguineus complex ecology and Mediterranean spotted fever epidemiology in France","volume":"6","author":"Gilot","year":"1990","journal-title":"Eur. J. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1007\/BF00144799","article-title":"Mediterranean spotted fever in Marseille: Descriptive epidemiology and the influence of climatic factors","volume":"8","author":"Raoult","year":"1992","journal-title":"Eur. J. Epidemiol."},{"key":"ref_30","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_31","doi-asserted-by":"crossref","unstructured":"Parola, P., Socolovschi, C., Jeanjean, L., Bitam, I., Fournier, P.E., Sotto, A., Labauge, P., and Raoult, D. (2008). Warmer weather linked to tick attack and emergence of severe rickettsioses. PLoS Negl. Trop. Dis., 2.","DOI":"10.1371\/journal.pntd.0000338"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.idc.2008.03.003","article-title":"Mediterranean spotted fever","volume":"22","author":"Rovery","year":"2008","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1603\/0022-2585-39.6.809","article-title":"Rickettsial infection in Dermacentor variabilis (Acari: Ixodidae) inhibits transovarial transmission of a second Rickettsia","volume":"39","author":"Macaluso","year":"2002","journal-title":"J. Med. Entomol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2307\/4577812","article-title":"Rocky mountain spotted fever: A study of the relationship between the presence of Rickettsia-like organisms in tick smears and the infectiveness of the same ticks","volume":"Volume 41","author":"Parker","year":"1926","journal-title":"Public Health Reports (1896\u20131970)"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3389\/fmicb.2010.00139","article-title":"Adherence to and invasion of host cells by spotted fever group Rickettsia species","volume":"1","author":"Chan","year":"2010","journal-title":"Front. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5272","DOI":"10.1128\/IAI.00201-09","article-title":"The Sca2 autotransporter protein from Rickettsia conorii is sufficient to mediate adherence to and invasion of cultured mammalian cells","volume":"77","author":"Cardwell","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.cell.2005.08.046","article-title":"Ku70, a component of DNA-dependent protein kinase, is a mammalian receptor for Rickettsia conorii","volume":"123","author":"Martinez","year":"2005","journal-title":"Cell"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1093\/molbev\/msi199","article-title":"Molecular evolution of Rickettsia surface antigens: Evidence of positive selection","volume":"22","author":"Blanc","year":"2005","journal-title":"Mol. Biol. Evol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Blanda, V., D\u2019Agostino, R., Giudice, E., Randazzo, K., La Russa, F., Villari, S., Vullo, S., and Torina, A. (2020). New real-time PCRs to differentiate Rickettsia spp. and Rickettsia conorii. Molecules, 25.","DOI":"10.3390\/molecules25194431"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.jmb.2004.01.057","article-title":"The membrane-associated form of the DNA repair protein Ku is involved in cell adhesion to fibronectin","volume":"337","author":"Monferran","year":"2004","journal-title":"J. Mol. Biol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"22136","DOI":"10.1074\/jbc.M301579200","article-title":"Novel localization of the DNA-PK complex in lipid rafts: A putative role in the signal transduction pathway of the ionizing radiation response","volume":"278","author":"Lucero","year":"2003","journal-title":"J. Biol. Chem."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1462-5822.2008.01279.x","article-title":"Rickettsial outer-membrane protein B (rOmpB) mediates bacterial invasion through Ku70 in an actin, c-Cbl, clathrin and caveolin 2-dependent manner","volume":"11","author":"Chan","year":"2009","journal-title":"Cell. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5097","DOI":"10.1242\/jcs.01382","article-title":"Early signaling events involved in the entry of Rickettsia conorii into mammalian cells","volume":"117","author":"Martinez","year":"2004","journal-title":"J. Cell Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1128\/IAI.00349-12","article-title":"The rickettsial OmpB \u03b2-peptide of Rickettsia conorii is sufficient to facilitate factor H-mediated serum resistance","volume":"80","author":"Riley","year":"2012","journal-title":"Infect. Immun."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/cmi.12068","article-title":"OmpA-mediated rickettsial adherence to and invasion of human endothelial cells is dependent upon interaction with alpha2beta1 integrin","volume":"15","author":"Hillman","year":"2013","journal-title":"Cell. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Sahni, A., Patel, J., Narra, H.P., Schroeder, C.L.C., Walker, D.H., and Sahni, S.K. (2017). Fibroblast growth factor receptor-1 mediates internalization of pathogenic spotted fever rickettsiae into host endothelium. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0183181"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"6104","DOI":"10.1128\/IAI.67.11.6104-6108.1999","article-title":"Identification and molecular analysis of the gene encoding Rickettsia typhi hemolysin","volume":"67","author":"Radulovic","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1086\/379080","article-title":"Identification and characterization of a phospholipase D-superfamily gene in Rickettsiae","volume":"188","author":"Renesto","year":"2003","journal-title":"J. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"6668","DOI":"10.1128\/IAI.73.10.6668-6673.2005","article-title":"Expression of the Rickettsia prowazekii pld or tlyC gene in Salmonella enterica serovar typhimurium mediates phagosomal escape","volume":"73","author":"Whitworth","year":"2005","journal-title":"Infect. Immun."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nature02318","article-title":"The RickA protein of Rickettsia conorii activates the Arp2\/3 complex","volume":"427","author":"Gouin","year":"2004","journal-title":"Nature"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4201","DOI":"10.1128\/IAI.67.8.4201-4207.1999","article-title":"Dynamics of actin-based movement by Rickettsia rickettsii in vero cells","volume":"67","author":"Heinzen","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"4706","DOI":"10.1128\/IAI.68.8.4706-4713.2000","article-title":"Ultrastructure of Rickettsia rickettsii actin tails and localization of cytoskeletal proteins","volume":"68","author":"Hayes","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"361","DOI":"10.4269\/ajtmh.1985.34.361","article-title":"Correlation of the distribution of Rickettsia conorii, microscopic lesions, and clinical features in South African tick bite fever","volume":"34","author":"Walker","year":"1985","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00430-017-0514-1","article-title":"Immune response against rickettsiae: Lessons from murine infection models","volume":"206","author":"Osterloh","year":"2017","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"5067","DOI":"10.1128\/IAI.00182-06","article-title":"Infection of human endothelial cells with spotted fever group rickettsiae stimulates cyclooxygenase 2 expression and release of vasoactive prostaglandins","volume":"74","author":"Rydkina","year":"2006","journal-title":"Infect. Immun."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"967852","DOI":"10.1155\/2012\/967852","article-title":"New insight into immunity and immunopathology of Rickettsial diseases","volume":"2012","author":"Mansueto","year":"2012","journal-title":"Clin. Dev. Immunol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2786","DOI":"10.1128\/iai.65.7.2786-2791.1997","article-title":"Rickettsia rickettsii infection of cultured human endothelial cells induces NF-kappaB activation","volume":"65","author":"Sporn","year":"1997","journal-title":"Infect. Immun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1128\/IAI.66.5.1827-1833.1998","article-title":"Proteasome-independent activation of nuclear factor kappaB in cytoplasmic extracts from human endothelial cells by Rickettsia rickettsii","volume":"66","author":"Sahni","year":"1998","journal-title":"Infect. Immun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1111\/j.1462-5822.2005.00574.x","article-title":"Activation of p38 stress-activated protein kinase during Rickettsia rickettsii infection of human endothelial cells: Role in the induction of chemokine response","volume":"7","author":"Rydkina","year":"2005","journal-title":"Cell. Microbiol."},{"key":"ref_60","first-page":"S1","article-title":"The IL-1 family and inflammatory diseases","volume":"20","author":"Dinarello","year":"2002","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2839","DOI":"10.1172\/JCI118354","article-title":"IL-6 and IL-8 production from cultured human endothelial cells stimulated by infection with Rickettsia conorii via a cell-associated IL-1 alpha-dependent pathway","volume":"96","author":"Kaplanski","year":"1995","journal-title":"J. Clin. Investig."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3733","DOI":"10.1128\/IAI.05008-11","article-title":"Beta interferon-mediated activation of signal transducer and activator of transcription protein 1 interferes with Rickettsia conorii replication in human endothelial cells","volume":"79","author":"Colonne","year":"2011","journal-title":"Infect. Immun."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1074\/mcp.M115.054361","article-title":"Endothelial cell proteomic response to Rickettsia conorii infection reveals activation of the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription (STAT)-Inferferon Stimulated Gene (ISG)15 pathway and reprogramming plasma membrane integrin\/cadherin signaling","volume":"15","author":"Zhao","year":"2016","journal-title":"Mol. Cell. Proteom. MCP"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"6729","DOI":"10.1128\/IAI.68.12.6729-6736.2000","article-title":"Mechanisms of intracellular killing of Rickettsia conorii in infected human endothelial cells, hepatocytes, and macrophages","volume":"68","author":"Feng","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1128\/iai.62.5.1952-1960.1994","article-title":"Depletion of gamma interferon and tumor necrosis factor alpha in mice with Rickettsia conorii-infected endothelium: Impairment of rickettsicidal nitric oxide production resulting in fatal, overwhelming rickettsial disease","volume":"62","author":"Feng","year":"1994","journal-title":"Infect. Immun."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Narra, H.P., Sahni, A., Khanipov, K., Fofanov, Y., and Sahni, S.K. (2019). Global transcriptomic profiling of pulmonary gene expression in an experimental murine model of Rickettsia conorii infection. Genes, 10.","DOI":"10.3390\/genes10030204"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1086\/519686","article-title":"Rickettsiae-stimulated dendritic cells mediate protection against lethal rickettsial challenge in an animal model of spotted fever rickettsiosis","volume":"196","author":"Jordan","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3389\/fcimb.2019.00043","article-title":"A pathogen and a non-pathogen spotted fever group rickettsia trigger differential proteome signatures in macrophages","volume":"9","author":"Curto","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_69","unstructured":"Allen, P.E., Noland, R.C., and Martinez, J.J. (2021). Rickettsia conorii survival in THP-1 macrophages involves host lipid droplet alterations and active rickettsial protein production. Cell. Microbiol., e13390."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3389\/fcimb.2019.00097","article-title":"Macrophages infected by a pathogen and a non-pathogen spotted fever group Rickettsia reveal differential reprogramming signatures early in infection","volume":"9","author":"Curto","year":"2019","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Sahni, A., Narra, H.P., and Sahni, S.K. (2020). Activation of mechanistic target of rapamycin (mTOR) in human endothelial cells infected with pathogenic spotted fever group rickettsiae. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21197179"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3014","DOI":"10.3389\/fimmu.2018.03014","article-title":"Enhancer associated long non-coding RNA transcription and gene regulation in experimental models of rickettsial infection","volume":"9","author":"Chowdhury","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1515\/hsz-2018-0389","article-title":"Evolution, purification, and characterization of RC0497: A peptidoglycan amidase from the prototypical spotted fever species Rickettsia conorii","volume":"401","author":"Patel","year":"2020","journal-title":"Biol. Chem."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.ajpath.2019.10.007","article-title":"Quantitative proteomics of the endothelial secretome identifies RC0497 as diagnostic of acute rickettsial spotted fever infections","volume":"190","author":"Zhao","year":"2020","journal-title":"Am. J. Pathol."},{"key":"ref_75","first-page":"333","article-title":"Clinico-epidemiological study of 164 cases of boutonneuse fever","volume":"176","year":"1985","journal-title":"Rev. Clin. Esp."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1186\/s40064-015-1042-3","article-title":"Mediterranean spotted fever: Case series of 24 years (1989\u20132012)","volume":"4","author":"Crespo","year":"2015","journal-title":"SpringerPlus"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s10096-002-0879-x","article-title":"Clinical and laboratory characteristics of 144 patients with Mediterranean spotted fever","volume":"22","author":"Anton","year":"2003","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Colomba, C., Saporito, L., Polara, V.F., Rubino, R., and Titone, L. (2006). Mediterranean spotted fever: Clinical and laboratory characteristics of 415 Sicilian children. BMC Infect. Dis., 6.","DOI":"10.1186\/1471-2334-6-60"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"845","DOI":"10.4269\/ajtmh.1986.35.845","article-title":"Mediterranean spotted fever: Clinical, laboratory and epidemiological features of 199 cases","volume":"35","author":"Raoult","year":"1986","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_80","first-page":"293","article-title":"Mediterranean spotted fever in childhood. Prospective study of 130 cases","volume":"28","year":"1988","journal-title":"An. Esp. Pediatr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ijid.2014.11.001","article-title":"Incidence of Mediterranean spotted fever in Sicilian children: A clinical-epidemiological observational retrospective study from 1987 to 2010","volume":"31","author":"Vitaliti","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"196","DOI":"10.20344\/amp.9713","article-title":"Mediterranean spotted fever in children: Study of a Portuguese endemic region","volume":"31","author":"Peixoto","year":"2018","journal-title":"Acta Med. Port."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s004310050859","article-title":"Clinical and laboratory findings of boutonneuse fever in Sicilian children","volume":"157","author":"Cascio","year":"1998","journal-title":"Eur. J. Pediatr."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"187","DOI":"10.21101\/cejph.a5608","article-title":"Mediterranean spotted fever in child and adult patients: Investigation from an endemic region in Bulgaria","volume":"28","author":"Baltadzhiev","year":"2020","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Herrador, Z., Fernandez-Martinez, A., Gomez-Barroso, D., Leon, I., Vieira, C., Muro, A., and Benito, A. (2017). Mediterranean spotted fever in Spain, 1997\u20132014: Epidemiological situation based on hospitalization records. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0174745"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/0035-9203(84)90163-9","article-title":"A sero-epidemiological survey of asymptomatic cases of Boutonneuse fever in western Sicily","volume":"78","author":"Mansueto","year":"1984","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_87","first-page":"446","article-title":"Epidemiologic aspects of Mediterranean Boutonneuse fever in the south of Corsica","volume":"78","author":"Raoult","year":"1985","journal-title":"Bull. Soc. Pathol. Exot. Fil."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1708-8305.2009.00391.x","article-title":"Diversity of life-threatening complications due to Mediterranean spotted fever in returning travelers","volume":"17","author":"Demeester","year":"2010","journal-title":"J. Travel Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0163-4453(86)93508-5","article-title":"Incidence, clinical observations and risk factors in the severe form of Mediterranean spotted fever among patients admitted to hospital in Marseilles 1983\u20131984","volume":"12","author":"Raoult","year":"1986","journal-title":"J. Infect."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1093\/jac\/dkr218","article-title":"Analysis of risk factors for malignant Mediterranean spotted fever indicates that fluoroquinolone treatment has a deleterious effect","volume":"66","author":"Rovery","year":"2011","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/infdis\/147.3.607","article-title":"Glucose-6-phosphate dehydrogenase deficiency in male patients with Mediterranean spotted fever in Sardinia","volume":"147","author":"Piras","year":"1983","journal-title":"J. Infect. Dis."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1086\/590211","article-title":"Host- and microbe-related risk factors for and pathophysiology of fatal Rickettsia conorii infection in Portuguese patients","volume":"198","author":"Sousa","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2478\/v10153-012-0006-4","article-title":"Mediterranean spotted fever\u2013classification by disease course and criteria for determining the disease severity","volume":"54","author":"Baltadzhiev","year":"2012","journal-title":"Folia Med. (Plovdiv)"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1093\/ajcp\/87.5.669","article-title":"The pathology of fatal Mediterranean spotted fever","volume":"87","author":"Walker","year":"1987","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_95","first-page":"421","article-title":"Coronary involvement in Mediterranean spotted fever","volume":"34","author":"Cascio","year":"2011","journal-title":"New Microbiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1099\/jmm.0.2008\/002162-0","article-title":"Atrial fibrillation in Mediterranean spotted fever","volume":"57","author":"Colomba","year":"2008","journal-title":"J. Med. Microbiol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.ejim.2005.03.008","article-title":"Cerebral infarction: An unusual complication of Mediterranean spotted fever","volume":"16","author":"Foucault","year":"2005","journal-title":"Eur. J. Intern. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.neurol.2010.07.010","article-title":"Meningoencephalitis caused by Rickettsia conorii in a young infant","volume":"167","author":"Bougteba","year":"2011","journal-title":"Rev. Neurol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jinf.2007.10.002","article-title":"Sensorineural hearing loss complicating severe rickettsial diseases: Report of two cases","volume":"56","author":"Tsiachris","year":"2008","journal-title":"J. Infect."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.nephro.2011.02.002","article-title":"Acute renal failure as a complication of Mediterranean spotted fever","volume":"7","author":"Montasser","year":"2011","journal-title":"Nephrol. Ther."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.2147\/OPTH.S21257","article-title":"Intraocular inflammation as the main manifestation of Rickettsia conorii infection","volume":"5","author":"Agahan","year":"2011","journal-title":"Clin. Ophthalmol."},{"key":"ref_102","first-page":"91","article-title":"Mediterranean spotted fever presenting as an acute pancreatitis","volume":"74","author":"Rombola","year":"2011","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1099\/jmm.0.025833-0","article-title":"Haemophagocytic syndrome and rickettsial diseases","volume":"60","author":"Cascio","year":"2011","journal-title":"J. Med. Microbiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1749-6632.2003.tb07383.x","article-title":"Evaluation of clinical diagnosis scores for Boutonneuse fever","volume":"990","author":"Letaief","year":"2003","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.cll.2017.01.009","article-title":"Rickettsiae as emerging infectious agents","volume":"37","author":"Fang","year":"2017","journal-title":"Clin. Lab. Med."},{"key":"ref_106","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. Microbiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1089\/vbz.2016.1966","article-title":"Guidelines for the detection of Rickettsia spp.","volume":"17","author":"Portillo","year":"2017","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1111\/j.1469-0691.2004.01019.x","article-title":"Guidelines for the diagnosis of tick-borne bacterial diseases in Europe","volume":"10","author":"Brouqui","year":"2004","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_109","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\u2014United States","volume":"65","author":"Biggs","year":"2016","journal-title":"MMWR Recomm. Rep."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1128\/jcm.30.2.455-460.1992","article-title":"Comparison of Western immunoblotting and microimmunofluorescence for diagnosis of Mediterranean spotted fever","volume":"30","author":"Teysseire","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"e286","DOI":"10.1017\/S0950268819001390","article-title":"Diagnosis of spotted fever group Rickettsia infections: The Asian perspective","volume":"147","author":"Robinson","year":"2019","journal-title":"Epidemiol. Infect."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"197","DOI":"10.4269\/ajtmh.1989.40.197","article-title":"Centrifugation-shell vial technique for rapid detection of Mediterranean spotted fever rickettsia in blood culture","volume":"40","author":"Marrero","year":"1989","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"4993","DOI":"10.1128\/JCM.43.10.4993-5002.2005","article-title":"Use of shell-vial cell culture assay for isolation of bacteria from clinical specimens: 13 years of experience","volume":"43","author":"Gouriet","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1128\/jcm.34.11.2722-2727.1996","article-title":"Diagnosis of Mediterranean spotted fever by cultivation of Rickettsia conorii from blood and skin samples using the centrifugation-shell vial technique and by detection of R. conorii in circulating endothelial cells: A 6-year follow-up","volume":"34","author":"Raoult","year":"1996","journal-title":"J. Clin. Microbiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3201\/eid1701.100854","article-title":"Identification of rickettsial infections by using cutaneous swab specimens and PCR","volume":"17","author":"Bechah","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.3201\/eid1710.110332","article-title":"Diagnosis of rickettsioses from eschar swab samples, Algeria","volume":"17","author":"Mouffok","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Angelakis, E., Richet, H., Rolain, J.M., La Scola, B., and Raoult, D. (2012). Comparison of real-time quantitative PCR and culture for the diagnosis of emerging Rickettsioses. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001540"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1099\/00207713-50-4-1449","article-title":"Phylogenetic analysis of members of the genus Rickettsia using the gene encoding the outer-membrane protein rOmpB (ompB)","volume":"50","author":"Roux","year":"2000","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1111\/j.1348-0421.2003.tb03448.x","article-title":"Phylogenetic analysis of spotted fever group rickettsiae based on gltA, 17-kDa, and rOmpA genes amplified by nested PCR from ticks in Japan","volume":"47","author":"Ishikura","year":"2003","journal-title":"Microbiol. Immunol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1128\/jcm.34.9.2058-2065.1996","article-title":"Differentiation of spotted fever group rickettsiae by sequencing and analysis of restriction fragment length polymorphism of PCR-amplified DNA of the gene encoding the protein rOmpA","volume":"34","author":"Roux","year":"1996","journal-title":"J. Clin. Microbiol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1586\/eri.12.139","article-title":"Treatment of Rickettsia spp. infections: A review","volume":"10","author":"Socolovschi","year":"2012","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1093\/infdis\/155.5.1059","article-title":"In vitro antibiotic susceptibility of Rickettsia rickettsii and Rickettsia conorii: Plaque assay and microplaque colorimetric assay","volume":"155","author":"Raoult","year":"1987","journal-title":"J. Infect. Dis."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1128\/AAC.42.7.1537","article-title":"In vitro susceptibilities of 27 rickettsiae to 13 antimicrobials","volume":"42","author":"Rolain","year":"1998","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1086\/338068","article-title":"Clarithromycin versus azithromycin in the treatment of Mediterranean spotted fever in children: A randomized controlled trial","volume":"34","author":"Cascio","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1128\/AAC.01814-15","article-title":"Randomized trial of clarithromycin for Mediterranean spotted fever","volume":"60","author":"Anton","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/jac\/dks089","article-title":"Deleterious effect of ciprofloxacin on Rickettsia conorii-infected cells is linked to toxin-antitoxin module up-regulation","volume":"67","author":"Edouard","year":"2012","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_127","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_128","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1517\/14740338.2016.1133584","article-title":"Revisiting doxycycline in pregnancy and early childhood\u2014Time to rebuild its reputation?","volume":"15","author":"Cross","year":"2016","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1097\/01.AOG.0000216197.26783.b5","article-title":"Antibiotic use in pregnancy and lactation: What is and is not known about teratogenic and toxic risks","volume":"107","author":"Nahum","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"ref_130","unstructured":"(2021, July 25). Doryx Drug Label, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2015\/050582s029lbl.pdf."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.jpeds.2015.02.015","article-title":"No visible dental staining in children treated with doxycycline for suspected Rocky Mountain Spotted Fever","volume":"166","author":"Todd","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"2887","DOI":"10.1093\/jac\/dkx245","article-title":"Dental staining after doxycycline use in children","volume":"72","author":"Nurmi","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1177\/1060028019863796","article-title":"Doxycycline and tooth discoloration in children: Changing of recommendations based on evidence of safety","volume":"53","author":"Stultz","year":"2019","journal-title":"Ann. Pharmacother."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1093\/infdis\/155.5.1056","article-title":"Comparative, randomized trial of one-day doxycycline versus 10-day tetracycline therapy for Mediterranean spotted fever","volume":"155","year":"1987","journal-title":"J. Infect. Dis."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0163-4453(89)93567-6","article-title":"Relapse of rickettsial Mediterranean spotted fever and murine typhus after treatment with chloramphenicol","volume":"18","author":"Shaked","year":"1989","journal-title":"J. Infect."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1128\/IAI.01324-10","article-title":"Molecular basis of immunity to rickettsial infection conferred through outer membrane protein B","volume":"79","author":"Chan","year":"2011","journal-title":"Infect. Immun."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/BF00145678","article-title":"Control of rickettsial diseases","volume":"7","author":"Kazar","year":"1991","journal-title":"Eur. J. Epidemiol."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s00436-014-4232-y","article-title":"Pilot study assessing the effectiveness of factory-treated, long-lasting permethrin-impregnated clothing for the prevention of tick bites during occupational tick exposure in highly infested military training areas, Germany","volume":"114","author":"Faulde","year":"2015","journal-title":"Parasitol. Res."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.amepre.2014.01.008","article-title":"Long-lasting permethrin impregnated uniforms: A randomized-controlled trial for tick bite prevention","volume":"46","author":"Vaughn","year":"2014","journal-title":"Am. J. Prev. Med."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1017\/S0031182011000709","article-title":"Eradication and control of livestock ticks: Biological, economic and social perspectives","volume":"138","author":"Walker","year":"2011","journal-title":"Parasitology"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Osterloh, A. (2020). The neglected challenge: Vaccination against rickettsiae. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008704"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s13071-019-3468-x","article-title":"Counterattacking the tick bite: Towards a rational design of anti-tick vaccines targeting pathogen transmission","volume":"12","author":"Rego","year":"2019","journal-title":"Parasites Vectors"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1128\/IAI.02888-14","article-title":"Identification of host proteins involved in rickettsial invasion of tick cells","volume":"83","author":"Petchampai","year":"2015","journal-title":"Infect. Immun."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/172\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:04:09Z","timestamp":1760166249000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/4\/172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,24]]},"references-count":143,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["tropicalmed6040172"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed6040172","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,24]]}}}