<i>Ehrlichia ewingii,</i>a Newly Recognized Agent of Human Ehrlichiosis

Buller, Richard S.; Arens, Max Q.; Hmiel, S P; Paddock, CD; Sumner, John W.; Rikhisa, Y; Ünver, Ahmet; Gaudreault‐Keener, Monique; Manian, Farrin A.; Liddell, Allison M.; Schmulewitz, N; Storch, Gregory A.

doi:10.1056/nejm199907153410303

Cited by 384 publications

(293 citation statements)

References 27 publications

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“…Following the description of the agent of Rocky Mountain spotted fever (RMSF) in 1906, 1 several clinically important tick-associated human infectious syndromes have since been characterized. [2][3][4][5][6][7][8][9][10] One tick-borne infection, human granulocytic anaplasmosis (HGA) caused by the rickettsia Anaplasma phagocytophilum, is transmitted by Ixodes scapularis ticks in the U.S. and can be sometimes confused with or complicates Lyme disease. A compilation of data published by the CDC and in Morbidity and Mortality Weekly Reports since HGA became nationally reportable includes at least 15,952 cases since 1995 ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Human Granulocytic Anaplasmosis

Bakken

Dumler

2008

Infectious Disease Clinics of North America

165

193

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SynopsisHuman granulocytic anaplasmosis (HGA), a deer tick transmitted rickettsial infection caused by Anaplasma phagocytophilum, is a common cause of undifferentiated fever in the Northeast and Upper Midwest U.S. Patients are often initially diagnosed with a mild viral infection, and illness readily resolves in most cases. However, as many as 3% may develop life threatening complications and nearly 1% die from the infection. A history of tick bite and a high degree of clinical suspicion thus warrant consideration for doxycycline treatment in both adults and children, even in the absence of known tick bite, a negative blood film examination, or pending results of specific A. phagocytophilum diagnostic tests such as paired serology or PCR on acute phase blood. Antibody tests and titers should not be used to monitor active infection as detectable antibodies can remain present for years. Moreover, persistent infection has never been reported. While coinfections with Borrelia burgdorferi and Babesia microti occur, there is little evidence to suggest synergism of disease or a role for A. phagocytophilum in chronic illness. Preventive measures include avoiding tick-infested areas, use of tick repellents, and careful searches of skin to remove attached ticks; no vaccine is available.

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Section: Introductionmentioning

confidence: 99%

Human Granulocytic Anaplasmosis

Bakken

Dumler

2008

Infectious Disease Clinics of North America

165

193

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“…Humans are incidental hosts of these pathogens, and the recent emergence of ehrlichiosis in humans has been associated with changes in ecology, demographics, and host susceptibility. 1 Ehrlichia chaffeensis, [2][3][4] Ehrlichia ewingii, 5,6 and Ehrlichia canis 7,8 cause ehrlichioses of medical and veterinary importance, with E. chaffeensis and E. canis being the primary agents of severe and sometimes fatal human monocytotropic ehrlichiosis (HME) and canine monocytic ehrlichiosis (CME), respectively. E. chaffeensis was first identified as an agent of human disease in 1987 in the United States, 2 whereas globally distributed E. canis was first identified in Africa as early as 1935 9 and in North America in 1962.…”

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confidence: 99%

Detection of Medically Important Ehrlichia by Quantitative Multicolor TaqMan Real-Time Polymerase Chain Reaction of the dsb Gene

Doyle

Labruna

Breitschwerdt

et al. 2005

The Journal of Molecular Diagnostics

219

117

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Ehrlichia species are the etiological agents of emerging and life-threatening tick-borne human zoonoses, in addition to causing serious and fatal infections in companion animals and livestock. We developed the first tricolor TaqMan real-time polymerase chain reaction assay capable of simultaneously detecting and discriminating medically important ehrlichiae in a single reaction. Analytical sensitivity of 50 copies per reaction was attained with templates from Ehrlichia chaffeensis, Ehrlichia ewingii, and Ehrlichia canis by amplifying the genus-specific disulfide bond formation protein gene (dsb). Ehrlichia genus-specific dsb primers amplified DNA from all known Ehrlichia species but not from other rickettsial organisms including Anaplasma platys, Anaplasma phagocytophilum, Rickettsia conorii, or Rickettsia typhi. High species specificity was attained as each species-specific TaqMan probe (E. chaffeensis, E. ewingii, and E. canis) identified homologous templates but did not cross-hybridize with heterologous Ehrlichia templates at concentrations as high as 10 8 copies. Identification of E. chaffeensis, E. ewingii, and E. canis from natural and experimental infections, previously confirmed by polymerase chain reaction and serological or microscopic evidence, demonstrated the comparable specificity and sensitivity of the dsb real-time assay. This assay provides a powerful tool for prospective medical diagnosis for human and canine ehrlichioses and for ecologic and epidemiological studies involving arthropod and mammalian hosts. (J Mol Diagn 2005, 7:504 -510)

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“…El diagnóstico clínico es difícil debido a lo inespecífico de estos síntomas. Además de éstas, se han descrito otras dos especies capaces de causar infección en humanos: Ehrlichia ewingii, que se ha encontrado en individuos inmunocomprometidos, cuyo reservorio es el perro y Amblyoma americanum su vector 4 , y Neorickettsia sennetsu, descrita en Asia en la década del 50, posiblemente transmitida a través de la ingesta de peces parasitados por helmintos 5 . Existe además una enorme variedad de otras especies descritas en distintas partes del mundo y que infectan otro tipo de animales.…”

Section: Introductionunclassified