RENO, Nev. (AP) — The top election official in a northern Nevada county key to winning the presidential battleground state is taking a stress-related leave of absence with just over a month to go before Election Day, creating a sense of uncertainty about election operations in a county that has been under near constant attack from election conspiracy theorists.

The announcement from Washoe County interim Registrar of Voters Cari-Ann Burgess is the latest high-level change to roil the elections office. A previous registrar resigned in 2022 after she received numerous threats and the replacement abruptly left a month before this year’s presidential primary season, thrusting Burgess into the spot in January.

Burgess’ duties will now be reassigned as the office prepares to send out mail ballots and gets ready for the start of early voting.

“She experienced stress issues and requested medical leave,” Washoe County spokeswoman Bethany Drysdale said Friday.

She said Burgess’ leave took effect Thursday and that county officials did not know whether she would return before the election.

Drysdale said there had been no documented threats against Burgess and the elections office, but she acknowledged the workplace was “a stressful environment” and that Burgess and the office had been targeted by negative comments. Drysdale didn’t offer specifics.

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Washoe County includes Reno and is Nevada’s second most populous, behind Clark County, which includes Las Vegas. Its elections operations have been in the spotlight ever since former President Donald Trump lost the state in 2020, under fire by a committed group of conspiracy theorists. Most recently, a dust-up over certification of the primary election results landed the county in uncharted legal territory and put it at odds with the Nevada attorney general and the state’s top election official.

Nevada’s secretary of state and attorney general were unsuccessful in their attempt to get the state Supreme Court to confirm the obligations for counties to certify results.

The commissioners eventually reversed course and voted to certify, but the rare move in the politically mixed swath of northern Nevada and the lack of clarity from the state’s high court raised concerns about certification battles after the November election.

With Burgess on leave, the Nevada Secretary of State’s office is providing advice and assistance to Washoe County. Deputy Registrar Andrew McDonald has taken the administrative role, Drysdale said, with staff and county administration stepping in to help.

“We will have a secure and safe and efficient election,” she said.

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Associated Press writers Ken Ritter in Las Vegas and Susan Montoya Bryan in Albuquerque, N.M., contributed to this report.