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<article xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" article-type="brief-report" xml:lang="EN"><?properties open_access?><front><journal-meta><journal-id journal-id-type="nlm-ta">Emerg Infect Dis</journal-id><journal-id journal-id-type="publisher-id">EID</journal-id><journal-title>Emerging Infectious Diseases</journal-title><issn pub-type="ppub">1080-6040</issn><issn pub-type="epub">1080-6059</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19046514</article-id><article-id pub-id-type="pmc">2634642</article-id><article-id pub-id-type="publisher-id">08-0860</article-id><article-id pub-id-type="doi">10.3201/eid1412.080860</article-id><article-categories><subj-group subj-group-type="heading"><subject>Dispatch</subject></subj-group></article-categories><title-group><article-title><italic>Rickettsia parkeri</italic> in Argentina</article-title><alt-title alt-title-type="running-head"><italic>Rickettsia parkeri</italic> in Argentina</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nava</surname><given-names>Santiago</given-names></name></contrib><contrib contrib-type="author"><name><surname>Elshenawy</surname><given-names>Yasmin</given-names></name></contrib><contrib contrib-type="author"><name><surname>Eremeeva</surname><given-names>Marina E.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Sumner</surname><given-names>John W.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Mastropaolo</surname><given-names>Mariano</given-names></name></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Paddock</surname><given-names>Christopher D.</given-names></name></contrib><aff id="aff1">Instituto Nacional de Tecnolog&#x000ed;a Agropecuaria, Santa Fe, Argentina (S. Nava, M. Mastropaolo)</aff><aff id="aff2">Centers for Disease Control and Prevention, Atlanta, Georgia, USA (Y. Elshenawy, M.E. Eremeeva, J.W. Sumner, C.D. Paddock)</aff></contrib-group><author-notes><corresp id="cor1">Address for correspondence: Christopher D. Paddock, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G32, Atlanta, GA 30333, USA; email: <email xlink:href="cdp9@cdc.gov">cdp9@cdc.gov</email></corresp></author-notes><pub-date pub-type="ppub"><month>12</month><year>2008</year></pub-date><volume>14</volume><issue>12</issue><fpage>1894</fpage><lpage>1897</lpage><abstract><p>Clinical reports of an eschar-associated rickettsiosis in the Paran&#x000e1; River Delta of Argentina prompted an evaluation of <italic>Amblyomma triste</italic> ticks in this region. When evaluated by PCR, 17 (7.6%) of 223 questing adult <italic>A. triste</italic> ticks, collected from 2 sites in the lower Paran&#x000e1; River Delta, contained DNA of <italic>Rickettsia parkeri</italic>.</p></abstract><kwd-group kwd-group-type="author" xml:lang="EN"><title>Keywords: </title><kwd><italic>Rickettsia parkeri</italic></kwd><kwd><italic>Amblyomma triste</italic></kwd><kwd>rickettsiosis</kwd><kwd>Argentina</kwd><kwd>dispatch</kwd></kwd-group></article-meta></front><body><p>Argentina is a large, ecologically diverse country, with at least 10 Neotropical <italic>Amblyomma</italic> tick species that bite humans, including <italic>Amblyomma triste</italic> (<xref ref-type="bibr" rid="R1"><italic>1</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R2"><italic>2</italic></xref>; <xref ref-type="fig" rid="F1">Figure 1</xref>, panels <bold>A</bold>, <bold>B</bold>). Spotted fever group rickettsiae have been identified in 3 <italic>Amblyomma</italic> species in Argentina: <italic>Rickettsia amblyommii</italic> and <italic>R. bellii</italic> in <italic>A. neumanni</italic> ticks from C&#x000f3;rdoba Province (<xref ref-type="bibr" rid="R3"><italic>3</italic></xref>), a novel <italic>Rickettsia</italic> sp. in <italic>A. parvum</italic> ticks from C&#x000f3;rdoba Province (<xref ref-type="bibr" rid="R4"><italic>4</italic></xref>), and <italic>R. rickettsii</italic> and <italic>R. bellii</italic> in <italic>A. cajennense</italic> ticks from Jujuy Province (<xref ref-type="bibr" rid="R5"><italic>5</italic></xref>). Human diseases in Argentina attributable to tick-borne rickettsiae have been recognized only recently, including several fatal cases of Rocky Mountain spotted fever caused by <italic>R. rickettsii</italic> in Jujuy Province (<xref ref-type="bibr" rid="R5"><italic>5</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R6"><italic>6</italic></xref>), and a milder, eschar-associated, spotted fever rickettsiosis in the Paran&#x000e1; River Delta of Buenos Aires Province (<xref ref-type="bibr" rid="R7"><italic>7</italic></xref>) that closely resembles a newly recognized rickettsial spotted fever in the United States caused by <italic>R. parkeri</italic> (<xref ref-type="bibr" rid="R8"><italic>8</italic></xref>). <italic>R. parkeri</italic> has been detected recently in <italic>A. triste</italic> ticks collected in Uruguay and Brazil (<xref ref-type="bibr" rid="R9"><italic>9</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R10"><italic>10</italic></xref>). We report the occurrence of <italic>R. parkeri</italic> in <italic>A. triste</italic> ticks collected along the Paran&#x000e1; River close to the locations of several recently identified cases of eschar-associated spotted fever.</p><fig id="F1" fig-type="figure" position="float"><label>Figure 1</label><caption><p>Adult female (A) and male (B) <italic>Amblyomma triste</italic> ticks and tick collection sites in the lower Paran&#x000e1; River Delta of Buenos Aires Province, Argentina, showing freshwater marsh habitats in the Reserva Natural Otamendi (C) and Estaci&#x000f3;n Experimental Instituto, Nacional de Tecnolog&#x000ed;a Agropecuaria, Delta del Paran&#x000e1; (D).</p></caption><graphic xlink:href="08-0860-F1"/></fig><sec sec-type="other1"><title>The Study</title><p>Tick collections occurred at 2 sites in Buenos Aires Province, Argentina, during January through December 2007: Reserva Natural Otamendi (34&#x000b0;15&#x02032;S, 58&#x000b0;52&#x02032;W) (<xref ref-type="fig" rid="F1">Figure 1</xref>, panel <bold>C</bold>) and Estaci&#x000f3;n Experimental, Instituto Nacional de Tecnolog&#x000ed;a Agropecuaria (INTA), Delta del Paran&#x000e1; (34&#x000b0;11&#x02032;S, 58&#x000b0;50&#x02032;W) (<xref ref-type="fig" rid="F1">Figure 1</xref>, panel <bold>D</bold>). Both are located in the lower Paran&#x000e1; River Delta region (<xref ref-type="fig" rid="F2">Figure 2</xref>), which is the southern extension of the Paranense Province of the Amazon Phytogeographic Dominion. The region is characterized by a system of levees that surround temporarily or permanently flooded freshwater marshes (<xref ref-type="bibr" rid="R11"><italic>11</italic></xref>). Humboldt&#x02019;s willow (<italic>Salix humboldtiana</italic>), Cockspur coral tree (<italic>Erythrina crista-galli</italic>), and <italic>Sapium hematospermum</italic> grow on the levees, and several species of bulrush (<italic>Scirpus giganteus, Schoenoplectus californicus</italic>, <italic>Scirpus americanus</italic>, and <italic>Typha</italic> sp.) and espada&#x000f1;a (<italic>Zizaniopsis bonariensis</italic>) comprise the dominant vegetation in the marshes. Medium to large mammals found at the study sites include wild marsh deer (<italic>Blastocerus dichotomus</italic>), capybara (<italic>Hydrochoerus hydrochaeris</italic>), pampas fox (<italic>Lycalopex gymnocercus</italic>), Geoffroy&#x02019;s cat (<italic>Oncifelis geoffroyi</italic>), cattle, horses, and dogs.</p><fig id="F2" fig-type="figure" position="float"><label>Figure 2</label><caption><p>A) Location of study area in the lower Paran&#x000e1; River Delta of Argentina. B) Tick collection sites along the Paran&#x000e1; River (dark circles) and a recently reported case of eschar-associated rickettsiosis (open circle) identified by clinicians in Buenos Aires Province, Argentina (<xref ref-type="bibr" rid="R7"><italic>7</italic></xref>).</p></caption><graphic xlink:href="08-0860-F2"/></fig><p>Questing adult ticks were collected from vegetation on the levees and in the marshes by using cloth flags and preserved in 96% ethanol. All ticks were identified by using standard taxonomic keys (<xref ref-type="bibr" rid="R12"><italic>12</italic></xref>). <italic>A. triste</italic> ticks were the only ticks collected from vegetation. For molecular analyses, individual specimens were removed from the ethanol solution, air-dried, and minced with a sterile scalpel blade. DNA was extracted by using a QIAamp DNA Mini-Kit (QIAGEN, Valencia, CA, USA) and eluted in a final volume of 100 &#x003bc;L. DNA extracts were evaluated by using a nested PCR designed to amplify a segment of the rickettsial outer membrane protein A gene (<italic>ompA</italic>) as described previously (<xref ref-type="bibr" rid="R13"><italic>13</italic></xref>). In brief, 5 &#x003bc;L of each DNA extract was used as template with primers 190.70 and 190.701 in the primary reaction. Two microliters of each completed primary reaction was used as template with primers 190-FN1 and 190-RN1 in the nested reactions. Primers were used at a final concentration of 300 nmol/L in a 50-&#x003bc;L reaction mixture. All amplicons were sequenced and compared to those in GenBank by using the BLAST 2.0 program (<ext-link ext-link-type="uri" xlink:href="http://blast.ncbi.nlm.nih.gov/blast.cgi">http://blast.ncbi.nlm.nih.gov/blast.cgi</ext-link>). Separate laboratory rooms were used for extracting tick DNA, performing primary and nested PCRs, and sequencing reactions. Water blanks were used for each primary and nested assay, and all extracts that provided amplicons of the expected size were retested to confirm the result.</p><p>Amplicons were obtained from DNA extracts of 4 (5.8%) of 69 <italic>A. triste</italic> ticks collected from Reserva Natural Otamendi and 13 (8.4%) of 154 ticks collected from Estaci&#x000f3;n Experimental INTA Delta del Paran&#x000e1; (<xref ref-type="table" rid="T1">Table</xref>). All 17 DNA samples produced amplicons of the expected sizes in primary reaction and nested reactions of the assay. Each 590-bp product (excluding primers) from the primary reaction was sequenced, and all sequences showed 100% identity with each other (GenBank accession no. FJ172358) and with the corresponding <italic>ompA</italic> sequence of <italic>R. parkeri</italic> (U43802).</p><table-wrap id="T1" position="float"><label>Table</label><caption><title>Prevalence of infection with <italic>Rickettsia parkeri</italic> in adult <italic>Amblyomma triste</italic> ticks collected in the lower Paran&#x000e1; River Delta, Buenos Aires Province, Argentina, 2007</title></caption><table frame="hsides" rules="groups"><col width="206" span="1"/><col width="78" span="1"/><col width="63" span="1"/><col width="63" span="1"/><col width="71" span="1"/><thead><tr><th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">Collection site</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">Month of collection</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">No. females &#x02028;(no. positive)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">No. males &#x02028;(no. positive)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">Total no. tested (no. positive)</th></tr></thead><tbody><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Reserva Natural Otamendi</td><td valign="top" align="center" rowspan="1" colspan="1">Jan</td><td valign="top" align="center" rowspan="1" colspan="1">20 (0)</td><td valign="top" align="center" rowspan="1" colspan="1">6 (0)</td><td valign="top" align="center" rowspan="1" colspan="1">26 (0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Mar</td><td valign="top" align="center" rowspan="1" colspan="1">5 (0)</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">5 (0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Jun</td><td valign="top" align="center" rowspan="1" colspan="1">1 (0)</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">1 (0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Jul</td><td valign="top" align="center" rowspan="1" colspan="1">2 (1)</td><td valign="top" align="center" rowspan="1" colspan="1">3 (0)</td><td valign="top" align="center" rowspan="1" colspan="1">5 (1)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Nov</td><td valign="top" align="center" rowspan="1" colspan="1">10 (0)</td><td valign="top" align="center" rowspan="1" colspan="1">5 (0)</td><td valign="top" align="center" rowspan="1" colspan="1">15 (0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"><hr/></td><td valign="top" align="center" rowspan="1" colspan="1">Dec<hr/></td><td valign="top" align="left" rowspan="1" colspan="1"><hr/></td><td valign="top" align="center" rowspan="1" colspan="1">17 (3)<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">17 (3)<hr/></td></tr><tr><td rowspan="3" valign="top" align="left" scope="row" colspan="1">Estaci&#x000f3;n Experimental, Instituto Nacional de Tecnolog&#x000ed;a&#x02028;Agropecuaria, Delta del Paran&#x000e1;<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">Aug</td><td valign="top" align="center" rowspan="1" colspan="1">60 (5)</td><td valign="top" align="center" rowspan="1" colspan="1">64 (3)</td><td valign="top" align="center" rowspan="1" colspan="1">124 (8)</td></tr><tr><td valign="top" colspan="1" align="center" scope="row" rowspan="1">Nov</td><td valign="top" align="center" rowspan="1" colspan="1">15 (4)</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">15 (4)</td></tr><tr><td valign="top" colspan="1" align="center" scope="row" rowspan="1">Dec<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">15 (1)<hr/></td><td valign="top" align="left" rowspan="1" colspan="1"><hr/></td><td valign="top" align="center" rowspan="1" colspan="1">15 (1)<hr/></td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Total</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">128 (11)</td><td valign="top" align="center" rowspan="1" colspan="1">95 (6)</td><td valign="top" align="center" rowspan="1" colspan="1">223 (17)</td></tr></tbody></table></table-wrap></sec><sec sec-type="conclusions"><title>Conclusions</title><p>This study provides definitive evidence of <italic>R. parkeri</italic> in Argentina. Our findings have relevance for public health because the infected ticks were collected from the lower Paran&#x000e1; River Delta near the origin of several recently identified cases of eschar-associated rickettsiosis (<xref ref-type="bibr" rid="R7"><italic>7</italic></xref>; Alfredo Seijo, pers. comm.). In Argentina, at least 15 species of hard ticks bite humans (<xref ref-type="bibr" rid="R1"><italic>1</italic></xref>); however, the only <italic>Amblyomma</italic> tick reported to bite humans in the lower Paran&#x000e1; River Delta is <italic>A. triste</italic> (<xref ref-type="bibr" rid="R2"><italic>2</italic></xref>). Our data suggest that <italic>A. triste</italic> ticks are vectors of <italic>R. parkeri</italic> in this region of Argentina. The prevalence of <italic>R. parkeri</italic>&#x02013;infected <italic>A. triste</italic> ticks identified at these 2 locations is within the range of the infection prevalence of this agent reported in questing adult ticks collected in the state of S&#x000e3;o Paulo, Brazil (9.7%) and in Canalones County in southern Uruguay (2.6%) (<xref ref-type="bibr" rid="R9"><italic>9</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R10"><italic>10</italic></xref>).</p><p>In South America, <italic>R. parkeri</italic> has been detected only in <italic>A. triste</italic> ticks (<xref ref-type="bibr" rid="R9"><italic>9</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R10"><italic>10</italic></xref>), and in the United States, <italic>R. parkeri</italic> is found almost exclusively in <italic>A. maculatum</italic> ticks (<xref ref-type="bibr" rid="R8"><italic>8</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R13"><italic>13</italic></xref>). <italic>A. triste</italic> and <italic>A. maculatum</italic> ticks are phylogenetically and morphologically similar, and <italic>R. parkeri</italic> appears to be strongly associated with these closely related tick species. Another human-biting Neotropical tick, <italic>A. tigrinum</italic>, is closely related to <italic>A. triste</italic> and <italic>A. maculatum</italic> ticks (<xref ref-type="bibr" rid="R12"><italic>12</italic></xref>)<italic>.</italic> In this context, <italic>A. tigrinum</italic> ticks may also be involved in the transmission of <italic>R. parkeri</italic> in South America. The distribution of <italic>A. triste</italic> ticks extends from Argentina to Mexico, but this tick has been reported to bite humans only in a few regions of Argentina, Uruguay, and Venezuela (<xref ref-type="bibr" rid="R1"><italic>1</italic></xref>). Because we are not aware of any records to indicate that immature stages of <italic>A. triste</italic> ticks will bite humans (<xref ref-type="bibr" rid="R1"><italic>1</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R2"><italic>2</italic></xref><italic>,</italic><xref ref-type="bibr" rid="R14"><italic>14</italic></xref>), our investigation focused on adult questing ticks for evidence of infection with <italic>R. parkeri</italic>. Preliminary studies indicate that peak adult <italic>A. triste</italic> abundance and activity in the lower Paran&#x000e1; River Delta occurs during August through November (S. Nava, unpub. data), similar to the seasonal distribution described for <italic>A. triste</italic> populations in southern Uruguay (<xref ref-type="bibr" rid="R14"><italic>14</italic></xref>); most cases of eschar-associated disease in Argentina occur during this same interval (<xref ref-type="bibr" rid="R7"><italic>7</italic></xref>; A. Seijo, pers. comm<italic>.</italic>)<italic>.</italic></p><p>No immature <italic>A. triste</italic> ticks were collected by flagging during this investigation. However, larvae and nymphs were found at these study sites attached to the guinea pig (<italic>Cavia aperea</italic>) amd several species of sigmodontine rodents, including Azara&#x02019;s grass mouse (<italic>Akodon azarae</italic>), the yellow pygmy rice rat (<italic>Oligoryzomys flavescens</italic>), the black-footed pygmy rice rat (<italic>O. nigripes</italic>), the red hocicudo (<italic>Oxymycterus rufus</italic>), and the Argentine swamp rat (<italic>Scapteromys aquaticus</italic>) (S. Nava, unpub. data<italic>).</italic> These findings suggest that one or more of these species may be involved in the natural transmission cycle of <italic>R. parkeri</italic> in this region.</p><p>Ecologic studies of <italic>A. triste</italic> ticks collected along the Paran&#x000e1; River in the states of S&#x000e3;o Paulo and Mato-Grosso do Sul in Brazil indicate that this tick is well-adapted to marsh habitats (<xref ref-type="bibr" rid="R15"><italic>15</italic></xref>); the results of this investigation support this observation. The occurrence of an <italic>R. parkeri</italic> rickettsiosis-like disease in humans in the Paran&#x000e1; River Delta suggests that similar cases of human illness may occur in palustrine regions of other Central and South American countries where this tick is found. Additional studies are needed to better understand the natural history of <italic>R. parkeri</italic> in Argentina and in other countries of the Western Hemisphere.</p></sec></body><back><fn-group><fn fn-type="citation"><p><italic>Suggested citation for this article</italic>: Nava S, Elshenawy Y, Eremeeva ME, Sumner JW, Mastropaolo M, Paddock CD. <italic>Rickettsia parkeri</italic> in Argentina. Emerg Infect Dis [serial on the Internet]. 2008 Dec [<italic>date cited</italic>]. Available from <ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/EID/content/14/12/1894.htm">http://www.cdc.gov/EID/content/14/12/1894.htm</ext-link></p></fn></fn-group><ack><title>Acknowledgments</title><p>We thank James Gathany for providing the photographs of <italic>A. triste</italic>, Zoi Antoniadou for assistance with the molecular studies, and Alberto Guglielmone for his critical review of the manuscript.</p><p>INTA, Asociaci&#x000f3;n Cooperadora INTA Rafaela, and Consejo Nacional de Investigaciones Cient&#x000ed;ficas y T&#x000e9;cnicas provided support to S.N. and M.M.</p></ack><bio><p>Dr Nava is a researcher with INTA in Santa Fe, Argentina. 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