“…The disease has been reported with increasing frequency in the United States and several European and Asian countries since the first case was reported in the United States in 1994 (3,7,9,12,15,18). A. phagocytophilum DNA has been detected in ticks collected in Israel, Japan, China, and elsewhere (8,14,16). HGA was first reported in China in 2008, and the first HGA outbreak was noteworthy because it caused nosocomial infection (20).…”