Editorial

Human Ehrlichiosis: Clinical and Ecological Challenges

Authors: John J. Openshaw, MSc, David L. Swerdlow, MD

Abstract

Cases of tick-borne zoonotic diseases such as Rocky Mountain Spotted Fever, Lyme disease, and the human ehrlichioses are on the rise in the United States.1,2 These emerging diseases are complex in their ecology, often perplexing in their clinical presentation, and challenging to diagnose. Lisa Prince et al3 in this month's Journal present a case of human monocytic ehrlichiosis (HME) and describe aspects of clinical diagnosis in the acute setting and laboratory diagnosis using serology and PCR.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Centers for Disease Control and Prevention. Lyme disease: United States, 2001–2002. MMWR2004;53:365–369.
 
2. Chapman AS, Murphy ST, Demma LJ, et al. Rocky Mountain spotted fever in the United States, 1997–2002. Vectorborne Zoonotic Dis 2006;6:170–178.
 
3. Prince LK, Shah AA, Martinez LJ, et al. Ehrlichiosis: making the diagnosis in the acute setting.South Med J 2007;100:825–828.
 
4. Paddock C, Childs JE. Ehrlichia chaffeensis a prototypical emerging pathogen. Clin Microbiol Rev2003;16:37–64.
 
5. Demma LJ, Holman RC, McQuiston JH, et al. Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 2001–2002. Am J Trop Med Hyg 2005;73:400–409.
 
6. Paddock CD, Folk SM, Shore GM, et al. Infections with Ehrlichia chaffeensis and Ehrlichia ewingii in persons coinfected with human immunodeficiency virus. Clin Infect Dis 2001;33:1586–1594.
 
7. Chapman AS, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis: United States: A practical guide for physicians and other health-care and public health professionals. MMWR Recommendations and Reports 2006;55(RR-4). Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr5504a1.htm. Accessed.
 
8. Mount GA, Haile DG, Barnard DR, et al. New version of LSTSIM for computer simulation ofAmblyomma americanum population dynamics. J. Med. Entomol 1993;30:843–857.
 
9. Ginsberg HS, Ewing CP, O'Connell AF, et al. Increased population densities of Amblyomma americanum on Long Island, NY. J. Parasitol 1991;77:493–495.
 
10. CDC. Ehrlichiosis (HGE, HME, other or unspecified): 2000 case definition. Atlanta, GA: US Department and Health and Human Services, CDC, Division of Public Health Surveillance and Informatics 2004. Available at: www.cdc.gov/epo/dphsi/casedef/ehrlichiosis_current.htm. Accessed.