Which statement about rickettsial infections is true?

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Rickettsial infections are mainly transmitted by arthropod vectors, not by direct human-to-human contact. Bacteria in the genus Rickettsia are obligate intracellular organisms that rely on vectors such as ticks, lice, fleas, or mites to move from animals to humans. When these vectors bite or contaminate the skin with their saliva or feces, the bacteria can enter the human body, causing illness. Because of this vector-borne mechanism, transmission from person to person through casual contact is not typical.

Mortality varies widely among rickettsial diseases and many cases respond to appropriate antibiotic treatment, so they are not universally fatal. The statement that all rickettsial infections are fatal is therefore incorrect. It is also incorrect to say that Rickettsia are never transmitted by arthropod vectors. Finally, direct contact with blood is not a recognized common mode of transmission for these infections, further underscoring that vector-based spread is the defining feature.