Abstract

The emerging tick-borne zoonoses human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) are under reported in the United States. From 1986 through 1997, 1,223 cases (742 HME, 449 HGE, and 32 not ascribed to a specific ehrlichial agent) were reported by state health departments. HME was most commonly reported from southeastern and southcentral states, while HGE was most often reported from northeastern and upper midwestern states. The annual number of reported cases increased sharply, from 69 in 1994 to 364 in 1997, coincident with an increase in the number of states making these conditions notifiable. From 1986 through 1997, 827 probable and confirmed cases were diagnosed by serologic testing at the Centers for Disease Control and Prevention, although how many of these cases were also reported by states is not known. Improved national surveillance would provide a better assessment of the public health importance of ehrlichiosis.

Highlights

  • The emerging tick-borne zoonoses human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) are underreported in the United States

  • HME and HGE are most often diagnosed by indirect immunofluorescence assay (IFA), polymerase chain reaction (PCR) assays are increasingly used [11]

  • We summarize the scope of state-supported surveillance efforts and present data on ehrlichiosis cases reported to state health departments from 1986 through 1997

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Summary

The Human Ehrlichioses in the United States

From 1986 through 1997, 1,223 cases (742 HME, 449 HGE, and 32 not ascribed to a specific ehrlichial agent) were reported by state health departments. From 1986 through 1997, 827 probable and confirmed cases were diagnosed by serologic testing at the Centers for Disease Control and Prevention, how many of these cases were reported by states is not known. Two etiologically and epidemiologically distinct forms of illness are recognized: human monocytic ehrlichiosis (HME), caused by Ehrlichia chaffeensis [1], and human granulocytic ehrlichiosis (HGE), caused by an agent similar or identical to the veterinary pathogens E. equi and E. phagocytophila [2]. We summarize the scope of state-supported surveillance efforts and present data on ehrlichiosis cases reported to state health departments from 1986 through 1997. We include data on ehrlichiosis cases diagnosed by serologic testing at the Centers for Disease Control and Prevention (CDC)

Reported Ehrlichiosis Cases in the United States
Human monocytic granulocytic ehrlichiosis ehrlichiosis
Conclusions
Findings
West Virginia
Full Text
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