Human Infection with Ehrlichia muris-like Pathogen, United States, 2007-2013(1)

Emerg Infect Dis. 2015 Oct;21(10):1794-9. doi: 10.3201/eid2110.150143.

Abstract

An Ehrlichia muris-like (EML) pathogen was detected among 4 patients in Minnesota and Wisconsin during 2009. We characterized additional cases clinically and epidemiologically. During 2004-2013, blood samples from 75,077 patients from all 50 United States were tested by PCR from the groEL gene for Ehrlichia spp. and Anaplasma phagocytophilum. During 2007-2013, samples from 69 (0.1%) patients were positive for the EML pathogen; patients were from 5 states: Indiana (1), Michigan (1), Minnesota (33), North Dakota (3), and Wisconsin (31). Most (64%) patients were male; median age was 63 (range 15-94) years; and all 69 patients reported likely tick exposure in Minnesota or Wisconsin. Fever, malaise, thrombocytopenia, and lymphopenia were the most common symptoms. Sixteen (23%) patients were hospitalized (median 4 days); all recovered, and 96% received doxycycline. Infection with the EML pathogen should be considered for persons reporting tick exposure in Minnesota or Wisconsin.

Keywords: Ehrlichia muris; Ixodes scapularis; United States; bacteria; ehrlichiosis; epidemiology; surveillance; tickborne infections; vector-borne infections; zoonoses.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaplasma phagocytophilum / genetics
  • Anaplasma phagocytophilum / pathogenicity*
  • Anaplasmataceae / genetics
  • Anaplasmataceae / pathogenicity*
  • Animals
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Serologic Tests / methods*
  • Ticks / parasitology*
  • Wisconsin / epidemiology
  • Zoonoses / epidemiology*
  • Zoonoses / transmission
  • Zoonoses / virology