title: Serological evidence of exposure to Rickettsia felis and Rickettsia typhi in Australian veterinarians.
abstract: BACKGROUND
  Rickettsia felis and Rickettsia typhi are emerging arthropod-borne zoonoses causing fever and flu-like symptoms. Seroprevalence and risk factors associated with exposure to these organisms was explored in Australian veterinarians.
  
  
  METHODS
  One hundred and thirty-one veterinarians from across Australia were recruited to participate in a cross-sectional survey. Veterinarians provided a single blood sample and answered a questionnaire on potential risk factors influencing their exposure to R. felis and R. typhi. Indirect microimmunofluorescence antibody testing (IFAT) was used to identify evidence of serological exposure of the participants to R. felis and R. typhi. Results were analyzed and a logistical regression model performed to predict risk factors associated with seropositivity.
  
  
  RESULTS
  In total, 16.0% of participants were seropositive to R. felis, 4.6% to R. typhi and 35.1% seropositive to both, where cross-reactivity of the IFAT between R. felis and R. typhi precluded a definitive diagnosis. Veterinarians residing within the south-eastern states of Victoria and Tasmania were at a higher risk of exposure to R. felis or generalised R. felis or R. typhi exposure. Older veterinarians and those that recommended flea treatment to their clients were found to be significantly protected from exposure.
  
  
  CONCLUSIONS
  The high exposure to R. felis amongst veterinary professionals suggests that flea-borne spotted fever is an important cause of undifferentiated fever conditions that may not be adequately recognized in Australia.
authors.affiliation: Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia. yen.teoh@unimelb.edu.au.
authors.forename: Yen Thon
authors.identifier: http://orcid.org/0000-0003-1836-8762
authors.initials: YT
authors.lastname: Teoh
authors.affiliation: The Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC, 3220, Australia.
authors.forename: Sze Fui
authors.initials: SF
authors.lastname: Hii
authors.affiliation: Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Stevenson
authors.affiliation: The Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC, 3220, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Graves
authors.affiliation: Bayer Animal Health, Tingalpa, QLD, 4173, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Rees
authors.affiliation: The Australian Rickettsial Reference Laboratory, University Hospital, Geelong, VIC, 3220, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Stenos
authors.affiliation: Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Traub
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005455:Fluorescent Antibody Technique; D008297:Male; D016273:Occupational Exposure; D012282:Rickettsia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D041161:Rickettsia felis / Q000276:immunology*; D012286:Rickettsia typhi / Q000276:immunology*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D005423:Siphonaptera / Q000382:microbiology; D011795:Surveys and Questionnaires; D018634:Veterinarians; D015047:Zoonoses
chemical_list: D000907:Antibodies, Bacterial
keywords: Australia; Rickettsia; Rickettsia felis; Rickettsia typhi; flea-borne spotted fever; murine typhus; veterinarian