New Jersey-Wide Survey of Spotted Fever Group (Proteobacteria: Rickettsiaceae) in and (Acari: Ixodida: Ixodidae)

For the last decade, the New Jersey (NJ) Department of Health has reported between 42 and 144 new cases each year of "spotted fever group rickettsiosis" (SFGR), a statistic that reflects uncertainty regarding which rickettsial agents (Proteobacteria: Rickettsiaceae: ) are infecting NJ residents. To identify the circulating in NJ ticks, we used a combination of conventional and real time PCR approaches to screen 560 Say and 245 L. obtained from a 1-day state-wide surveillance in May 2018 and an additional 394 collected across NJ in 2013-2018. We found zero infected with the agent of Rocky Mountain spotted fever and, on average, 1.3% infected with presumed nonpathogenic . We also found zero infected with and 20% infected with a prevalence somewhat lower than in more southern states. Overall, we conclude that it is unlikely that vectored by is a primary cause of SFGR cases in NJ and discuss our findings in the context of known facts and current limitations. We conclude that understanding the causes of SFGR east of the Mississippi will require collaboration among medical doctors, public health authorities, and medical entomologists to follow up presumptive human cases of SFGR with detailed histories of exposure, species-specific molecular assays, and active surveillance of putative vectors and the pathogens they may carry.