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A 43-year-old man is being evaluated in the hospital for headache, abdominal pain, and generalized weakness. He was hospitalized the day before for a 12-day history of fever. He is a marathon runner and less than a month ago participated in a 42 km run near the northern Congo basin. He denies any tick bit, although he was bitten extensively by mosquitos during the run. He was in close proximity to both the local populace and wildlife. On physical exam, he appears very ill. Vital signs show temperature 39.9 C, blood pressure 102/64 mmHg, and pulse 100/min. There is significant cervical lymphadenopathy and a vesicular rash seen on the wrists and involving the palms. After isolation, empiric doxycycline is started. Two days after treatment, he fails to defervesce, and the rash starts climbing both arms, and now involves both shins, feet, and soles. What is the most likely vector for the patient's infection?
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