{"id":"https://openalex.org/W7213412469","doi":"https://doi.org/10.1016/j.onehlt.2026.101543","title":"Coinfection patterns and associations of tick-borne pathogens in natural foci of severe fever with thrombocytopenia syndrome: A One Health approach","display_name":"Coinfection patterns and associations of tick-borne pathogens in natural foci of severe fever with thrombocytopenia syndrome: A One Health approach","publication_year":2026,"publication_date":"2026-09-17","ids":{"openalex":"https://openalex.org/W7213412469","doi":"https://doi.org/10.1016/j.onehlt.2026.101543","pmid":"https://pubmed.ncbi.nlm.nih.gov/42991458","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13737371"},"language":"en","primary_location":{"id":"doi:10.1016/j.onehlt.2026.101543","doi":"https://doi.org/10.1016/j.onehlt.2026.101543","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.onehlt.2026.101543","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2352771426002272/pdf","source":{"id":"https://openalex.org/S2898245483","display_name":"One Health","issn_l":"2352-7714","issn":["2352-7714"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"One Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.sciencedirect.com/science/article/pii/S2352771426002272/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5151882608","display_name":"Zhiyi Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I24943067","display_name":"Fudan University","ror":"https://ror.org/013q1eq08","country_code":"CN","type":"education","lineage":["https://openalex.org/I24943067"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhiyi Zhang","raw_affiliation_strings":["Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China","School of Public Health, Fudan University, Shanghai, China","Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]},{"raw_affiliation_string":"School of Public Health, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]},{"raw_affiliation_string":"Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151886339","display_name":"Bingzhi Chen","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bingzhi Chen","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5032099375","display_name":"Yishuang Zhao","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yishuang Zhao","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151924674","display_name":"Xiang Zheng","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Xiang Zheng","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151910986","display_name":"Qing Gao","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Qing Gao","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151893182","display_name":"Hongbiao Liang","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hongbiao Liang","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151897598","display_name":"Haijiang Lin","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Haijiang Lin","raw_affiliation_strings":["Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5151905856","display_name":"Na He","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I24943067","display_name":"Fudan University","ror":"https://ror.org/013q1eq08","country_code":"CN","type":"education","lineage":["https://openalex.org/I24943067"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Na He","raw_affiliation_strings":["Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China","School of Public Health, Fudan University, Shanghai, China","Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]},{"raw_affiliation_string":"School of Public Health, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]},{"raw_affiliation_string":"Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China","institution_ids":["https://openalex.org/I24943067"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5151897598","https://openalex.org/A5151905856"],"corresponding_institution_ids":["https://openalex.org/I24943067"],"apc_list":{"value":3080,"currency":"USD","value_usd":3080},"apc_paid":{"value":3080,"currency":"USD","value_usd":3080},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.65920826,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"23","issue":null,"first_page":"101543","last_page":"101543"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10296","display_name":"Vector-borne infectious diseases","score":0.8086000084877014,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10296","display_name":"Vector-borne infectious diseases","score":0.8086000084877014,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12047","display_name":"Viral Infections and Vectors","score":0.18960000574588776,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12492","display_name":"Zoonotic diseases and public health","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/severe-fever-with-thrombocytopenia-syndrome","display_name":"severe fever with thrombocytopenia syndrome","score":0.9779999852180481},{"id":"https://openalex.org/keywords/tick-borne-pathogens","display_name":"tick-borne pathogens","score":0.9860000014305115},{"id":"https://openalex.org/keywords/coinfection","display_name":"co-infection","score":0.9829999804496765},{"id":"https://openalex.org/keywords/anaplasma","display_name":"Anaplasma","score":0.8090000152587891},{"id":"https://openalex.org/keywords/ehrlichia","display_name":"Ehrlichia","score":0.8690000176429749},{"id":"https://openalex.org/keywords/bartonella","display_name":"Bartonella","score":0.843999981880188},{"id":"https://openalex.org/keywords/coxiella","display_name":"Coxiella","score":0.9909999966621399},{"id":"https://openalex.org/keywords/spotted-fever-group-rickettsiae","display_name":"spotted fever group rickettsiae","score":0.9919999837875366},{"id":"https://openalex.org/keywords/small-mammals","display_name":"small mammals","score":0.7200000286102295},{"id":"https://openalex.org/keywords/ticks","display_name":"ticks","score":0.9340000152587891},{"id":"https://openalex.org/keywords/cross-host-transmission","display_name":"cross-host transmission","score":0.8029999732971191},{"id":"https://openalex.org/keywords/taizhou","display_name":"Taizhou","score":0.7649999856948853}],"concepts":[{"id":"https://openalex.org/C2777813720","wikidata":"https://www.wikidata.org/wiki/Q1243018","display_name":"Coinfection","level":3,"score":0.828499972820282},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5663999915122986},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.5293999910354614},{"id":"https://openalex.org/C159047783","wikidata":"https://www.wikidata.org/wiki/Q7215","display_name":"Virology","level":1,"score":0.5102999806404114},{"id":"https://openalex.org/C2909982947","wikidata":"https://www.wikidata.org/wiki/Q5282130","display_name":"Disease reservoir","level":2,"score":0.38960000872612},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.3531999886035919},{"id":"https://openalex.org/C2779310458","wikidata":"https://www.wikidata.org/wiki/Q1405631","display_name":"Fever of unknown origin","level":2,"score":0.3474000096321106},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.3239000141620636},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.30820000171661377},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.2955999970436096},{"id":"https://openalex.org/C2776353676","wikidata":"https://www.wikidata.org/wiki/Q182672","display_name":"Zoonosis","level":2,"score":0.29499998688697815},{"id":"https://openalex.org/C163276114","wikidata":"https://www.wikidata.org/wiki/Q484591","display_name":"Natural history","level":2,"score":0.2840000092983246},{"id":"https://openalex.org/C2781458928","wikidata":"https://www.wikidata.org/wiki/Q1361531","display_name":"Natural reservoir","level":3,"score":0.265500009059906}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1016/j.onehlt.2026.101543","doi":"https://doi.org/10.1016/j.onehlt.2026.101543","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.onehlt.2026.101543","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2352771426002272/pdf","source":{"id":"https://openalex.org/S2898245483","display_name":"One Health","issn_l":"2352-7714","issn":["2352-7714"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"One Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13737371","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13737371/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13737371/pdf/main.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"One Health","raw_type":"Text"},{"id":"pmid:42991458","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42991458","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"One health (Amsterdam, Netherlands)","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:3437be46eeab4237a88a7362f957c924","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/3437be46eeab4237a88a7362f957c924","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"One Health, Vol 23, Iss , Pp 101543- (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.onehlt.2026.101543","doi":"https://doi.org/10.1016/j.onehlt.2026.101543","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.onehlt.2026.101543","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2352771426002272/pdf","source":{"id":"https://openalex.org/S2898245483","display_name":"One Health","issn_l":"2352-7714","issn":["2352-7714"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"One Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[{"id":"https://openalex.org/G9000359683","display_name":null,"funder_award_id":"DGF201016","funder_id":"https://openalex.org/F4320321851","funder_display_name":"Fudan University"},{"id":"https://openalex.org/G9000361613","display_name":null,"funder_award_id":"DGF201006","funder_id":"https://openalex.org/F4320321851","funder_display_name":"Fudan University"},{"id":"https://openalex.org/G9000362552","display_name":null,"funder_award_id":"DGF201004","funder_id":"https://openalex.org/F4320321851","funder_display_name":"Fudan University"}],"funders":[{"id":"https://openalex.org/F4320321851","display_name":"Fudan University","ror":"https://ror.org/013q1eq08"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7213412469.pdf","grobid_xml":"https://content.openalex.org/works/W7213412469.grobid-xml"},"referenced_works_count":50,"referenced_works":["https://openalex.org/W94874521","https://openalex.org/W1865580826","https://openalex.org/W2020136993","https://openalex.org/W2020466371","https://openalex.org/W2028494524","https://openalex.org/W2071243023","https://openalex.org/W2077188722","https://openalex.org/W2137060930","https://openalex.org/W2157951249","https://openalex.org/W2172081451","https://openalex.org/W2174977049","https://openalex.org/W2179701521","https://openalex.org/W2275258036","https://openalex.org/W2297137482","https://openalex.org/W2325680555","https://openalex.org/W2325856592","https://openalex.org/W2402308883","https://openalex.org/W2527736503","https://openalex.org/W2544517987","https://openalex.org/W2545582609","https://openalex.org/W2746317377","https://openalex.org/W2795604177","https://openalex.org/W2808194168","https://openalex.org/W2835889514","https://openalex.org/W2905193019","https://openalex.org/W2998724286","https://openalex.org/W3088142516","https://openalex.org/W3103781808","https://openalex.org/W3130651652","https://openalex.org/W3194285209","https://openalex.org/W4213431500","https://openalex.org/W4280583344","https://openalex.org/W4283206604","https://openalex.org/W4283819616","https://openalex.org/W4287877478","https://openalex.org/W4295956533","https://openalex.org/W4304845606","https://openalex.org/W4309503091","https://openalex.org/W4309506513","https://openalex.org/W4362660576","https://openalex.org/W4385327314","https://openalex.org/W4386781873","https://openalex.org/W4387653986","https://openalex.org/W4387826652","https://openalex.org/W4388757384","https://openalex.org/W4389274275","https://openalex.org/W4402316862","https://openalex.org/W4402956074","https://openalex.org/W4403114324","https://openalex.org/W4411739896"],"related_works":["https://openalex.org/W3171723110","https://openalex.org/W2572636917","https://openalex.org/W7127615381","https://openalex.org/W4389030933","https://openalex.org/W4366504081","https://openalex.org/W7037575910","https://openalex.org/W2976722688","https://openalex.org/W2164040996","https://openalex.org/W7171708400","https://openalex.org/W6920904342"],"abstract_inverted_index":{"Background":[0],"Tick-borne":[1],"pathogens":[2],"(TBPs)":[3],"circulate":[4],"in":[5,40,136,155,162,172,179,205,238,269],"complex":[6],"ecological":[7],"systems":[8],"involving":[9,214],"vectors,":[10],"animal":[11],"hosts,":[12],"and":[13,23,63,78,99,105,123,138,152,157,185,193,198,216,223,263,281],"humans.":[14],"Coinfections":[15],"have":[16],"been":[17],"shown":[18],"to":[19],"influence":[20],"clinical":[21],"outcomes":[22],"may":[24],"complicate":[25],"pathogen":[26,97,271],"associations,":[27,104],"yet":[28],"current":[29],"research":[30],"remains":[31],"limited.":[32,142],"Methods":[33],"We":[34,94],"adopted":[35],"a":[36,43,248,274],"One":[37,275],"Health":[38,276],"approach":[39,277],"Taizhou":[41],"City,":[42],"severe":[44],"fever":[45,80],"with":[46,125,174,182,233],"thrombocytopenia":[47],"syndrome":[48],"(SFTS)":[49],"endemic":[50],"area,":[51,209],"by":[52],"collecting":[53],"485":[54],"community":[55,175,183,199],"residents,":[56,176,184],"90":[57],"confirmed":[58],"SFTS":[59,207],"patients,":[60],"1081":[61],"ticks,":[62,120],"471":[64],"small":[65,121,139,163,180,217,234,267],"mammals.":[66,164,218,235],"Five":[67],"TBPs,":[68],"including":[69],"Anaplasma":[70,148,158,189,194,219],"spp.,":[71,73,75,77,220,222],"Bartonella":[72,177,228],"Coxiella":[74,160],"Ehrlichia":[76,150,153,191,221],"spotted":[79],"group":[81],"rickettsiae":[82],"(SFGR),":[83],"were":[84,117,141,146],"detected":[85,118],"using":[86],"indirect":[87],"immunofluorescence":[88],"assay":[89],"or":[90,243],"polymerase":[91],"chain":[92],"reaction.":[93],"subsequently":[95],"analyzed":[96],"prevalence":[98,126],"coinfection":[100],"patterns,":[101],"assessed":[102],"pathogen-pathogen":[103,144],"evaluated":[106],"cross-host":[107],"correlations":[108,166],"at":[109],"the":[110,264,285],"township":[111],"level.":[112],"Results":[113],"All":[114],"five":[115],"TBPs":[116,203],"across":[119],"mammals,":[122],"humans,":[124,156,279],"varying":[127],"substantially.":[128],"Human":[129],"IgG":[130,236],"showed":[131],"diverse":[132],"co-seropositivity,":[133],"while":[134,227,273],"coinfections":[135],"ticks":[137,173,197,215],"mammals":[140,181,268],"Significant":[143],"associations":[145,169],"observed:":[147],"spp./":[149,159,190],"spp.":[151,161,178,192,229],"spp./SFGR":[154,195],"Cross-host":[165],"included":[167],"positive":[168],"of":[170,188,266,287],"SFGR":[171,224],"significant":[186],"links":[187],"between":[196],"residents.":[200],"Conclusions":[201],"Multiple":[202],"co-circulate":[204],"this":[206],"epidemic":[208],"following":[210],"distinct":[211],"exposure":[212],"routes":[213],"are":[225],"tick-borne,":[226],"is":[230],"more":[231,288],"associated":[232],"co-seropositivity":[237],"humans":[239],"likely":[240],"reflects":[241],"repeated":[242],"long-term":[244],"exposures":[245],"rather":[246],"than":[247],"single":[249],"tick":[250],"bite.":[251],"These":[252],"findings":[253],"suggest":[254],"that":[255],"effective":[256],"prevention":[257],"should":[258],"consider":[259],"human":[260],"activity":[261],"patterns":[262],"role":[265],"sustaining":[270],"circulation,":[272],"integrating":[278],"animals,":[280],"vectors":[282],"can":[283],"guide":[284],"development":[286],"targeted":[289],"control":[290],"strategies.":[291]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-09-17T00:00:00"}
