RENO, Nev. — The top election official in a key northern Nevada swing county 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 conspiracy theorists since former President Donald Trump lost it in 2020.

The announcement regarding Washoe County interim Registrar of Voters Cari-Ann Burgess is the latest high-level change to roil the elections office. It might also be the most consequential departure spurred by the years-long campaign against election administrators sparked by Trump’s false claims that fraud cost him reelection four years ago.

Burgess was the third registrar since 2020 in Washoe, which includes Reno and has become critical for any candidate piecing together a statewide win in Nevada, one of at least seven highly competitive states in November’s presidential election.

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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 role in January. Burgess said Friday she had no immediate comment.

“She experienced stress issues and requested medical leave,” Washoe County spokeswoman Bethany Drysdale said Friday, adding that she did not know if Burgess would return before the election.

Burgess’ duties will now be reassigned as the office prepares to send out mail ballots and gets ready for the start of early voting. Acknowledging that all eyes will be on Washoe County on election night, George Guthrie, a spokesperson for the registrar’s office, said they are prepared to process ballots from every active registered voter.

“We have to plan for record turnout. That’s what we’re expecting,” he said.

Election officials across the country have been bracing for a tumultuous election, installing panic buttons and bulletproof glass amid a spike in threats against those who count ballots. The Bipartisan Policy Center found a 38% increase in the turnover rate among election officials in a survey published earlier this year.

“This is continuing to drive people from the profession at the worst possible time,” said Tammy Patrick, program director for the National Association of Election Officials.

“The election officials I speak to are singularly focused on conducting the election, but people can only be pushed so far,” she said. “Everyone has a breaking point, and unfortunately there are some people who want to push the system to the brink.”

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.

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 Trump lost the state in 2020, under fire by a committed group of conspiracy theorists. Two of its five county commissioners themselves have the support of the 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. It said in a statement Friday that it “fully supports” the county registrar’s office but declined to elaborate on what it called “county personnel issues.”

Deputy Registrar Andrew McDonald has taken the administrative role in the meantime, Drysdale said, with staff and county administration stepping in to help.

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

• Yamat reported from Las Vegas and Riccardi from Denver. Associated Press writers Ken Ritter in Las Vegas and Susan Montoya Bryan in Albuquerque, N.M., contributed to this report.