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Background  Mediterranean Spotted Fever (MSF), whose etiological agent is  R. conorii,  is one of the oldest described vector-borne infectious diseases. Although it is endemic in the Mediterranean area, clinical cases have also been reported in other regions.  R. massiliae- Bar29 is related to MSF cases. This strain is distributed worldwide.  R. conorii  and  R. massiliae- Bar29 are transmitted by ticks. Dogs are considered the sentinel of  R. conorii  infection. Cats could also be involved in their transmission.  Rickettsia felis,  etiological agent of Flea-borne spotted fever ,  is mainly transmitted by the cat flea,  Ctenocephalides felis . Up to now, the role of cats in its transmission is not entirely elucidated. The aim of the study is to analyze the infection in cats by these microorganisms.    Methods  The study was undertaken in Northeastern Spain. Twenty municipalities of seven regions participated in the study. 212 cats (pets and stray cats) were analyzed. Variables surveyed were: date of collection, age, sex, municipality, source, living place, outdoor activities, health status, type of disease, contact with other animals, and ectoparasite infestation. Sera were evaluated by indirect immunofluorescence antibody assay (IFA). Molecular detection (real-time PCR and sequencing) and cultures were performed on blood samples.    Results  There were 59 (27.8%) cats seroreactive to one or more microorganisms. Considering cross-reactions, the seroprevalences were 15.6%-19.5% ( R. massiliae -Bar29), 1.9%-6.2% ( R. conorii) , and 5.2%-7.5% ( R. felis ). A weak association was observed between SFG seropositivity and tick infestation. Ticks found on seropositive cats were  Rhipicephalus pusillus, R. sanguineus  and  R. turanicus.  DNA of  Rickettsia  was detected in 23 cats. 21 of them could be sequenced. Sequences obtained were identical to those sequences of SFG rickettsiae similar to  R. conorii  and  R. massiliae . No amplification of  R. felis  was obtained.    Conclusions  Cats can be infected by SFG rickettsiae and produce antibodies against them. Cats may play a role in the transmission cycle of  R. conorii  and  R. massiliae -Bar29, although the role in the  R. felis  cycle needs further analysis.

The role of cats in the eco-epidemiology of spotted fever group diseases