Seroepidemiologic study of human infections with spotted fever group rickettsiae in North Carolina

Meagan F. Vaughn, Josie Delisle, Joey Johnson, Gaylen Daves, Carl Williams, Jodi Reber, Nicole L. Mendell, Donald H. Bouyer, William L. Nicholson, Abelardo C. Moncayo, Steven R. Meshnick

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Increasing entomologic and epidemiologic evidence suggests that spotted fever group rickettsiae (SFGR) other than Rickettsia rickettsii are responsible for spotted fever rickettsioses in the United States. A retrospective seroepidemiologic study was conducted on stored acute- and convalescent-phase sera that had been submitted for Rocky Mountain spotted fever testing to the North Carolina State Laboratory of Public Health. We evaluated the serologic reactivity of the paired sera to R. rickettsii, Rickettsia parkeri, and Rickettsia amblyommii antigens. Of the 106 eligible pairs tested, 21 patients seroconverted to one or more antigens. Cross-reactivity to multiple antigens was observed in 10 patients, and seroconversions to single antigens occurred in 11 patients, including 1 against R. rickettsii, 4 against R. parkeri, and 6 against R. amblyommii. Cross-absorption of cross-reactive sera and/or Western blots identified two presumptive cases of infection with R. parkeri, two presumptive cases of infection with R. rickettsii, and one presumptive case of infection with R. amblyommii. These findings suggest that species of SFGR other than R. rickettsii are associated with illness among North Carolina residents and that serologic testing using R. rickettsii antigen may miss cases of spotted fever rickettsioses caused by other species of SFGR.

Original languageEnglish (US)
Pages (from-to)3960-3966
Number of pages7
JournalJournal of Clinical Microbiology
Issue number11
StatePublished - Nov 1 2014

ASJC Scopus subject areas

  • Microbiology (medical)


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