Materiały źródłowe

• #1 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Ehrlichiosis and anaplasmosis are emerging infections in the United States and worldwide. In the United States, these infections are the most frequently recorded tick-borne diseases after Lyme disease, with estimated case fatality rates of 2.7% and 0.3%, respectively. The increase in these tick-borne diseases is a public health concern because the tick population is increasing mainly due to climate change. The geographic distribution of ticks is expanding, and more cases are being reported. Efforts to perform surveillance are being used to understand the ecology and distribution of the ticks, their reservoirs, and the endemic areas for infections transmitted through ticks. […] The changing epidemiology of Ehrlichia and the geographical distribution of the reservoir, the white-tailed deer, and the lone star tick depend on many factors. Abiotic factors, such as temperature and humidity, and biotic factors, such as vegetation density and shade, along with climate change, result in warmer temperatures in higher latitudes and can increase the geographic expansion of vectors and reservoirs. Changes in the white-tailed deer populations, for any reason, affect the epidemiology of human monocytic ehrlichiosis.

• #2 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is an infection of white blood cells that affects various mammals, including mice, cattle, dogs, deer, horses, sheep, goats, and humans. […] The distribution of ehrlichiosis in the United States mirrors the tick distribution and appropriate mammalian vectors (eg, white-footed mouse, white-tailed deer). Ehrlichiosis occurs where mammalian hosts are in contact with the appropriate tick vector (ie, A americanum,D variabilis,Ixodes ticks). […] Most cases of ehrlichiosis in the United States occur in California and Texas and in the southeast and northeast regions of the country, with some cases occurring in the north-central states west of the Great Lakes. […] In 2016, 4 states (Missouri, Arkansas, New York, Virginia) accounted for 50% of all reported cases of ehrlichiosis in the United States.

• #3 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. […] Ehrlichiosis and anaplasmosis are related to rickettsial diseases. […] Most cases of monocytic ehrlichiosis have been identified in the southeastern and south central United States, where its arthropod vector (the lone star tick) is endemic. […] Anaplasma phagocytophilum (formerly E. phagocytophila) causes human granulocytic anaplasmosis, which occurs in the Northeast, mid-Atlantic, upper Midwest and West Coast of the United States, where its arthropod vector (ixodid ticks) is endemic. […] Several cases of anaplasmosis have been reported after blood transfusions from asymptomatic or acutely infected donors. […] Because Lyme disease, babesiosis, and Powassan virus have the same tick vector and endemic area as anaplasmosis, ticks (and thus the people they bite) may be infected with more than one type of organism at the same time.

• #4 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  The reported incidence of E chaffeensis from 2000 to 2007 increased from 0.80 to 3.0 cases per million persons per year, and the case fatality rate and hospitalization rates were 1.9% and 49%, respectively. From 2008 to 2012, 4613 cases of E chaffeensis and 55 cases of E ewingii were reported through the CDC in the United States. The incidence rate was 3.2 cases per million person-years, the hospitalization rate was 57%, and the case fatality rate was 1%. The highest case fatality rate was 4%, reported in children younger than 5. Until 2012, the rate of ehrlichiosis had increased 4-fold since 2000. […] Symptoms may range from mild to severe and can even be fatal if not treated, especially if infected with E chaffeensis and A phagocytophilum. Patients who are older or immunocompromised may have worse outcomes if not treated promptly. Ehrlichiosis and anaplasmosis can also be transmitted through blood transfusions, which have been increasingly reported, especially in patients with hematological or solid tumor malignancies and transplantation. Cases in adults and children can be mild and subclinical, or clinicians may not consider the disease in the differential diagnosis. Thus, the disease may be underdiagnosed and under-reported.

• #5 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  The reported incidence of E chaffeensis from 2000 to 2007 increased from 0.80 to 3.0 cases per million persons per year, and the case fatality rate and hospitalization rates were 1.9% and 49%, respectively. From 2008 to 2012, 4613 cases of E chaffeensis and 55 cases of E ewingii were reported through the CDC in the United States. The incidence rate was 3.2 cases per million person-years, the hospitalization rate was 57%, and the case fatality rate was 1%. The highest case fatality rate was 4%, reported in children younger than 5. Until 2012, the rate of ehrlichiosis had increased 4-fold since 2000. […] Symptoms may range from mild to severe and can even be fatal if not treated, especially if infected with E chaffeensis and A phagocytophilum. Patients who are older or immunocompromised may have worse outcomes if not treated promptly. Ehrlichiosis and anaplasmosis can also be transmitted through blood transfusions, which have been increasingly reported, especially in patients with hematological or solid tumor malignancies and transplantation. Cases in adults and children can be mild and subclinical, or clinicians may not consider the disease in the differential diagnosis. Thus, the disease may be underdiagnosed and under-reported.

• #6 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #7 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #8 Human ehrlichiosis and anaplasmosis – UpToDate

  https://www.uptodate.com/contents/human-ehrlichiosis-and-anaplasmosis/print

  The epidemiology, clinical manifestations, diagnosis, and treatment of human ehrlichiosis and anaplasmosis are reviewed here. […] In 2009, a third species of Ehrlichia was identified in four patients from Wisconsin and Minnesota who had fever, malaise, headache, and lymphopenia; more than 100 cases have been subsequently reported. […] Then in 2023, cases possibly due to a new species, candidatus Ehrlichia erythraense, were reported by investigators in China. These cases highlight our expanding understanding of the range and variety of Ehrlichiae.

• #9 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Recorded cases of anaplasmosis rose from 537 in 2004 to 4151 cases in 2016; in a recent report, 4151 cases were reported annually. Human granulocytic anaplasmosis can be severe, with 36% of patients requiring hospitalization and 3% with life-threatening complications. Other reports have stated that up to 17% of hospitalized patients required admission to the intensive care unit.

• #10 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Recorded cases of anaplasmosis rose from 537 in 2004 to 4151 cases in 2016; in a recent report, 4151 cases were reported annually. Human granulocytic anaplasmosis can be severe, with 36% of patients requiring hospitalization and 3% with life-threatening complications. Other reports have stated that up to 17% of hospitalized patients required admission to the intensive care unit.

• #11 Statistics | Anaplasmosis | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/anaplasmosis/stats/index.html

  Anaplasmosis was first recognized as a disease of humans in the United States in the mid-1990s, but did not become a reportable disease until 1999. CDC compiles the number of cases reported by state health departments. […] The number of anaplasmosis cases reported to CDC has increased steadily since the disease became reportable, from 348 cases in 2000, to 1761 cases in 2010. […] Anaplasmosis is most frequently reported from the upper midwestern and northeastern United States. […] Six states (New York, Connecticut, New Jersey, Rhode Island, Minnesota, and Wisconsin) account for 90% of all reported cases of anaplasmosis. […] Although cases of anaplasmosis can occur during any month of the year, the majority of cases reported to the CDC have an illness onset during the summer months and a peak in cases typically occurs in the months of June and July.

• #12 Statistics | Anaplasmosis | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/anaplasmosis/stats/index.html

  Anaplasmosis was first recognized as a disease of humans in the United States in the mid-1990s, but did not become a reportable disease until 1999. CDC compiles the number of cases reported by state health departments. […] The number of anaplasmosis cases reported to CDC has increased steadily since the disease became reportable, from 348 cases in 2000, to 1761 cases in 2010. […] Anaplasmosis is most frequently reported from the upper midwestern and northeastern United States. […] Six states (New York, Connecticut, New Jersey, Rhode Island, Minnesota, and Wisconsin) account for 90% of all reported cases of anaplasmosis. […] Although cases of anaplasmosis can occur during any month of the year, the majority of cases reported to the CDC have an illness onset during the summer months and a peak in cases typically occurs in the months of June and July.

• #13 Undetermined Human Ehrlichiosis and Anaplasmosis in the United States, 2008–2012: A Catch-All for Passive Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4751933/

  Taking all the etiologies together, the reported incidence rate of human ehrlichiosis and anaplasmosis in the United States is 10 cases per million person-years, an increase of 40% from 2000 to 2007. […] Enhanced surveillance at sites where multiple agents of human ehrlichiosis and anaplasmosis are endemic may help interpret national trends in this catch-all category.

• #14 EPIDEMIOLOGY OF HUMAN EHRLICHIOSIS AND ANAPLASMOSIS IN THE UNITED STATES, 2001–2002 in: The American Journal of Tropical Medicine and Hygiene Volume 73 Issue 2 (2005)

  https://www.ajtmh.org/abstract/journals/tpmd/73/2/article-p400.xml

  During 2001 through 2002, 1,176 cases of the tick-borne diseases human monocytic ehrlichiosis (HME) and human granulocytic anaplasmosis (HGA) were reported to the Centers for Disease Control and Prevention (CDC) by 32 states through the National Electronic Telecommunications System for Surveillance. The average reported annual incidences for HME and HGA during 2001-2002 were 0.6 and 1.4 cases per million population, respectively; incidence was highest among men 60 years of age. […] The surveillance information retrieved from CRFs has allowed for qualitative evaluation of ehrlichiosis and anaplasmosis risk factors, severity, and diagnostic accuracy. […] Although these surveillance systems likely substantially under-represent the true burden of ehrlichiosis and anaplasmosis in the United States due to poor recognition and reporting, they represent the first compilation of national data since these diseases were made nationally notifiable. Continued and improved surveillance activities will progressively reinforce our understanding and awareness of these newly recognized zoonotic infections.

• #15 Ehrlichiosis and Anaplasmosis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/ehrlichiosis-and-anaplasmosis/

  Incidence Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from prevalence, which refers to all cases in the population at a given time. Measures of Disease Frequency in the United States:

• #16 Epidemiology of Ehrlichiosis and Anaplasmosis among American Indians in the United States, 2000–2007 in: The American Journal of Tropical Medicine and Hygiene Volume 87 Issue 3 (2012)

  https://www.ajtmh.org/view/journals/tpmd/87/3/article-p529.xml

  Ehrlichiosis and anaplasmosis infections among American Indians (AIs) have never been specifically examined, despite high rates of other tick-borne rickettsial diseases among AIs. The epidemiology of ehrlichiosis and anaplasmosis among AIs was analyzed using the National Electronic Telecommunications System for Surveillance (NETSS), Case Report Forms (CRFs), and Indian Health Service (IHS) inpatient and outpatient visits. The 2000-2007 average annual ehrlichiosis and anaplasmosis incidence among AIs reported to NETSS was almost 4-fold lower (4.0/1,000,000) than that using IHS data (14.9). American Indian cases reported from CRFs had a higher proportion of hospitalization (44%) compared with IHS (10%). American Indian incidence of ehrlichiosis and anaplasmosis was higher and showed a different age and geographical distribution than other races. These results highlight the need to improve collaboration between the ehrlichiosis and anaplasmosis surveillance systems for AIs so as to develop interventions that target the unique epidemiology and mitigate the burden of disease among this high-risk population.

• #17 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is an infection of white blood cells that affects various mammals, including mice, cattle, dogs, deer, horses, sheep, goats, and humans. […] The distribution of ehrlichiosis in the United States mirrors the tick distribution and appropriate mammalian vectors (eg, white-footed mouse, white-tailed deer). Ehrlichiosis occurs where mammalian hosts are in contact with the appropriate tick vector (ie, A americanum,D variabilis,Ixodes ticks). […] Most cases of ehrlichiosis in the United States occur in California and Texas and in the southeast and northeast regions of the country, with some cases occurring in the north-central states west of the Great Lakes. […] In 2016, 4 states (Missouri, Arkansas, New York, Virginia) accounted for 50% of all reported cases of ehrlichiosis in the United States.

• #18 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is an infection of white blood cells that affects various mammals, including mice, cattle, dogs, deer, horses, sheep, goats, and humans. […] The distribution of ehrlichiosis in the United States mirrors the tick distribution and appropriate mammalian vectors (eg, white-footed mouse, white-tailed deer). Ehrlichiosis occurs where mammalian hosts are in contact with the appropriate tick vector (ie, A americanum,D variabilis,Ixodes ticks). […] Most cases of ehrlichiosis in the United States occur in California and Texas and in the southeast and northeast regions of the country, with some cases occurring in the north-central states west of the Great Lakes. […] In 2016, 4 states (Missouri, Arkansas, New York, Virginia) accounted for 50% of all reported cases of ehrlichiosis in the United States.

• #19 Ehrlichiosis and Anaplasmosis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/ehrlichiosis-and-anaplasmosis/

  Incidence Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from prevalence, which refers to all cases in the population at a given time. Measures of Disease Frequency in the United States:

• #20 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. […] Ehrlichiosis and anaplasmosis are related to rickettsial diseases. […] Most cases of monocytic ehrlichiosis have been identified in the southeastern and south central United States, where its arthropod vector (the lone star tick) is endemic. […] Anaplasma phagocytophilum (formerly E. phagocytophila) causes human granulocytic anaplasmosis, which occurs in the Northeast, mid-Atlantic, upper Midwest and West Coast of the United States, where its arthropod vector (ixodid ticks) is endemic. […] Several cases of anaplasmosis have been reported after blood transfusions from asymptomatic or acutely infected donors. […] Because Lyme disease, babesiosis, and Powassan virus have the same tick vector and endemic area as anaplasmosis, ticks (and thus the people they bite) may be infected with more than one type of organism at the same time.

• #21 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Mammalian reservoirs for A phagocytophilum include small mammals such as mice, chipmunks, and voles. […] The distribution of the tick determines where human infections occur. The lone star tick, which transmits both E chaffeensis and E ewingii, is found in the Southeastern, Mid-Atlantic, Midwestern, and South Central United States. A phagocytophilum is transmitted by the black-legged tick, Ixodes scapularis, which is found in the Eastern United States, and by the western black-legged tick, Ixodes pacificus, which is found in the Western United States.

• #22 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. […] Ehrlichiosis and anaplasmosis are related to rickettsial diseases. […] Most cases of monocytic ehrlichiosis have been identified in the southeastern and south central United States, where its arthropod vector (the lone star tick) is endemic. […] Anaplasma phagocytophilum (formerly E. phagocytophila) causes human granulocytic anaplasmosis, which occurs in the Northeast, mid-Atlantic, upper Midwest and West Coast of the United States, where its arthropod vector (ixodid ticks) is endemic. […] Several cases of anaplasmosis have been reported after blood transfusions from asymptomatic or acutely infected donors. […] Because Lyme disease, babesiosis, and Powassan virus have the same tick vector and endemic area as anaplasmosis, ticks (and thus the people they bite) may be infected with more than one type of organism at the same time.

• #23 Statistics | Anaplasmosis | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/anaplasmosis/stats/index.html

  Anaplasmosis was first recognized as a disease of humans in the United States in the mid-1990s, but did not become a reportable disease until 1999. CDC compiles the number of cases reported by state health departments. […] The number of anaplasmosis cases reported to CDC has increased steadily since the disease became reportable, from 348 cases in 2000, to 1761 cases in 2010. […] Anaplasmosis is most frequently reported from the upper midwestern and northeastern United States. […] Six states (New York, Connecticut, New Jersey, Rhode Island, Minnesota, and Wisconsin) account for 90% of all reported cases of anaplasmosis. […] Although cases of anaplasmosis can occur during any month of the year, the majority of cases reported to the CDC have an illness onset during the summer months and a peak in cases typically occurs in the months of June and July.

• #24 Anaplasma / Ehrlichia – Swissticks

  https://swissticks.ch/en/pathogens/anaplasma-ehrlichia/

  In Europe, Anaplasma phagocytophilum is transmitted primarily by the tick species Ixodes ricinus. This tick species also transmits several other important pathogens, such as Borrelia burgdorferi and tick-borne encephalitis virus. The prevalence of Anaplasma phagocytophilum in Ixodes ricinus ticks varies in different countries in Europe; in Switzerland it is estimated at 1.7% (2019). […] In the US, anaplasmosis is common in the northeastern and central-northern regions toward Canada (13 cases per million population). In the US, the causative agent of anaplasmosis is mainly transmitted by the tick species I. scapularis and I. pacificus. Anaplasmosis can therefore also occur in travelers returning from these endemic areas.

• #25 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #26 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  There are about 800 cases of anaplasmosis and 800 cases of human monocytic ehrlichiosis each year in the US. The incidence of E ewingii infection is uncertain because there is serologic cross-reactivity between it and E chaffeensis. […] About 80-90% of cases of ehrlichiosis occur from April to September. […] Rates of reported cases of ehrlichiosis increase with age; most patients are older adults (usually 40 years). This pattern contrasts with age-specific incidence of Rocky Mountain spotted fever, which occurs most frequently in children. […] Ehrlichiosis and anaplasmosis are all transmitted from mammalian reservoirs to humans by hard ticks. […] The mammalian reservoirs for E chaffeensis and E ewingii include white-tailed deer, elk, rodents, coyote, fox, wolves, raccoon, opossum, and dogs.

• #27 Ehrlichiosis and Anaplasmosis | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617797/2.1.1/Ehrlichiosis_and_Anaplasmosis

  HME typically occurs in the midwest, south central, and southeastern United States, mirroring the pattern of Rocky Mountain spotted fever (RMSF). In addition, it has been found in Europe, South America, Asia, and Africa. […] HGA typically occurs in the north central, northeastern United States, and northern California, similar to Lyme disease. Most patients are infected during April through September, the months of greatest tick and human outdoor activity. […] A second peak of HGA occurs from late October to December.

• #28 Anaplasmosis, 2019 – MN Dept. of Health

  https://www.health.state.mn.us/diseases/reportable/dcn/sum19/anaplasmosis.html

  Anaplasmosis is a rickettsial disease caused by the disease agent Anaplasma phagocytophilum, which is transmitted by bites from Ixodes scapularis, the blacklegged tick. […] In 2019, 407 confirmed or probable cases of anaplasmosis (7.2 cases per 100,000) were reported, down from the 496 cases reported in 2018. […] Yearly case totals over time continue to trend upward, with a median of 620 cases reported per year since 2010. […] In 2019, 245 (60%) confirmed or probable cases reported were male. […] As is typical, most cases had illness onsets during the summer months, with 69% of cases reporting illness onsets in June, July, or August. […] In 2019, 133 (33%) cases were hospitalized for their anaplasmosis infection, with a median duration of 4 admission days (range, 2 to 374 days). […] Thirty-three (8%) cases reported complications (e.g., organ failure) due to anaplasmosis infection.

• #29 Statistics | Anaplasmosis | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/anaplasmosis/stats/index.html

  Anaplasmosis was first recognized as a disease of humans in the United States in the mid-1990s, but did not become a reportable disease until 1999. CDC compiles the number of cases reported by state health departments. […] The number of anaplasmosis cases reported to CDC has increased steadily since the disease became reportable, from 348 cases in 2000, to 1761 cases in 2010. […] Anaplasmosis is most frequently reported from the upper midwestern and northeastern United States. […] Six states (New York, Connecticut, New Jersey, Rhode Island, Minnesota, and Wisconsin) account for 90% of all reported cases of anaplasmosis. […] Although cases of anaplasmosis can occur during any month of the year, the majority of cases reported to the CDC have an illness onset during the summer months and a peak in cases typically occurs in the months of June and July.

• #30 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #31 EPIDEMIOLOGY OF HUMAN EHRLICHIOSIS AND ANAPLASMOSIS IN THE UNITED STATES, 2001–2002 in: The American Journal of Tropical Medicine and Hygiene Volume 73 Issue 2 (2005)

  https://www.ajtmh.org/abstract/journals/tpmd/73/2/article-p400.xml

  During 2001 through 2002, 1,176 cases of the tick-borne diseases human monocytic ehrlichiosis (HME) and human granulocytic anaplasmosis (HGA) were reported to the Centers for Disease Control and Prevention (CDC) by 32 states through the National Electronic Telecommunications System for Surveillance. The average reported annual incidences for HME and HGA during 2001-2002 were 0.6 and 1.4 cases per million population, respectively; incidence was highest among men 60 years of age. […] The surveillance information retrieved from CRFs has allowed for qualitative evaluation of ehrlichiosis and anaplasmosis risk factors, severity, and diagnostic accuracy. […] Although these surveillance systems likely substantially under-represent the true burden of ehrlichiosis and anaplasmosis in the United States due to poor recognition and reporting, they represent the first compilation of national data since these diseases were made nationally notifiable. Continued and improved surveillance activities will progressively reinforce our understanding and awareness of these newly recognized zoonotic infections.

• #32 Statistics | Anaplasmosis | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/anaplasmosis/stats/index.html

  The frequency of reported cases of anaplasmosis is highest among males and people over 40 years of age. […] This reporting category reflects cases that showed clinical and laboratory signs consistent with either an ehrlichiosis or anaplasmosis infection, but which could not be attributed to a specific organism due to the limitations of diagnostic test results. […] Demma LJ, Holman RC, McQuiston JH, Krebs JW, Swerdlow DL. Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 20012002. American Journal of Tropical Medicine and Hygiene (73)2005,400

• #33 Anaplasmosis, 2019 – MN Dept. of Health

  https://www.health.state.mn.us/diseases/reportable/dcn/sum19/anaplasmosis.html

  Anaplasmosis is a rickettsial disease caused by the disease agent Anaplasma phagocytophilum, which is transmitted by bites from Ixodes scapularis, the blacklegged tick. […] In 2019, 407 confirmed or probable cases of anaplasmosis (7.2 cases per 100,000) were reported, down from the 496 cases reported in 2018. […] Yearly case totals over time continue to trend upward, with a median of 620 cases reported per year since 2010. […] In 2019, 245 (60%) confirmed or probable cases reported were male. […] As is typical, most cases had illness onsets during the summer months, with 69% of cases reporting illness onsets in June, July, or August. […] In 2019, 133 (33%) cases were hospitalized for their anaplasmosis infection, with a median duration of 4 admission days (range, 2 to 374 days). […] Thirty-three (8%) cases reported complications (e.g., organ failure) due to anaplasmosis infection.

• #34 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  The reported incidence of E chaffeensis from 2000 to 2007 increased from 0.80 to 3.0 cases per million persons per year, and the case fatality rate and hospitalization rates were 1.9% and 49%, respectively. From 2008 to 2012, 4613 cases of E chaffeensis and 55 cases of E ewingii were reported through the CDC in the United States. The incidence rate was 3.2 cases per million person-years, the hospitalization rate was 57%, and the case fatality rate was 1%. The highest case fatality rate was 4%, reported in children younger than 5. Until 2012, the rate of ehrlichiosis had increased 4-fold since 2000. […] Symptoms may range from mild to severe and can even be fatal if not treated, especially if infected with E chaffeensis and A phagocytophilum. Patients who are older or immunocompromised may have worse outcomes if not treated promptly. Ehrlichiosis and anaplasmosis can also be transmitted through blood transfusions, which have been increasingly reported, especially in patients with hematological or solid tumor malignancies and transplantation. Cases in adults and children can be mild and subclinical, or clinicians may not consider the disease in the differential diagnosis. Thus, the disease may be underdiagnosed and under-reported.

• #35 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. […] Ehrlichiosis and anaplasmosis are related to rickettsial diseases. […] Most cases of monocytic ehrlichiosis have been identified in the southeastern and south central United States, where its arthropod vector (the lone star tick) is endemic. […] Anaplasma phagocytophilum (formerly E. phagocytophila) causes human granulocytic anaplasmosis, which occurs in the Northeast, mid-Atlantic, upper Midwest and West Coast of the United States, where its arthropod vector (ixodid ticks) is endemic. […] Several cases of anaplasmosis have been reported after blood transfusions from asymptomatic or acutely infected donors. […] Because Lyme disease, babesiosis, and Powassan virus have the same tick vector and endemic area as anaplasmosis, ticks (and thus the people they bite) may be infected with more than one type of organism at the same time.

• #36 Guideline for veterinary practitioners on canine ehrlichiosis and anaplasmosis in Europe | Parasites & Vectors | Full Text

  https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-015-0649-0

  In general, another route of transmission is through blood transfusion. Due to the potential transmission of these pathogens via infected blood, screening canine blood products for bacterial DNA with a polymerase chain reaction (PCR) assay is recommended in highly endemic areas to ensure the safety of blood products. […] Information on canine ehrlichiosis and anaplasmosis in Europe has significantly increased in the last few years. This guideline aimed to answer common questions of interest on the etiology, transmission, epidemiology, clinical signs, laboratory findings, diagnosis, therapy, and prophylaxis of infections caused by Ehrlichia and Anaplasma spp. This guideline contributes to the understanding of the current status of these diseases on the European continent. However, these pathogens are spreading to new niches, and reports have described infections in many countries where they were not detected previously.

• #37 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  There are about 800 cases of anaplasmosis and 800 cases of human monocytic ehrlichiosis each year in the US. The incidence of E ewingii infection is uncertain because there is serologic cross-reactivity between it and E chaffeensis. […] About 80-90% of cases of ehrlichiosis occur from April to September. […] Rates of reported cases of ehrlichiosis increase with age; most patients are older adults (usually 40 years). This pattern contrasts with age-specific incidence of Rocky Mountain spotted fever, which occurs most frequently in children. […] Ehrlichiosis and anaplasmosis are all transmitted from mammalian reservoirs to humans by hard ticks. […] The mammalian reservoirs for E chaffeensis and E ewingii include white-tailed deer, elk, rodents, coyote, fox, wolves, raccoon, opossum, and dogs.

• #38 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Mammalian reservoirs for A phagocytophilum include small mammals such as mice, chipmunks, and voles. […] The distribution of the tick determines where human infections occur. The lone star tick, which transmits both E chaffeensis and E ewingii, is found in the Southeastern, Mid-Atlantic, Midwestern, and South Central United States. A phagocytophilum is transmitted by the black-legged tick, Ixodes scapularis, which is found in the Eastern United States, and by the western black-legged tick, Ixodes pacificus, which is found in the Western United States.

• #39 Ehrlichiosis, Anaplasmosis, and Related Infections in Animals – Infectious Diseases – MSD Veterinary Manual

  https://www.msdvetmanual.com/generalized-conditions/rickettsial-diseases/ehrlichiosis-anaplasmosis-and-related-infections-in-animals

  Ehrlichiosis is a tick-transmitted disease that infects blood cells and can cause a variety of signs from none to fever and generalized achiness to possible fatality. […] Ehrlichiosis is an infection caused by obligate, intracellular bacteria that primarily affect cells of the immune system in dogs, cats, and people. […] In the USA, E chaffeensis and E ewingii are transmitted by Amblyomma americanum, the lone star tick. […] Prevention of ehrlichiosis and anaplasmosis is accomplished by controlling ticks on dogs. […] Multiple ehrlichioses and anaplasmoses may be transmitted by ticks from wildlife to pets and people (or from dog to dog in the case of canine monocytic ehrlichiosis). […] Ehrlichiosis and anaplasmosis have similar clinical manifestations, with acute fever and hematologic abnormalities. […] Maintaining an index of suspicion for infection based on known tick activity, and using appropriate diagnostic testing, are important to make diagnoses of ehrlichiosis and anaplasmosis and to implement effective treatment.

• #40 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Mammalian reservoirs for A phagocytophilum include small mammals such as mice, chipmunks, and voles. […] The distribution of the tick determines where human infections occur. The lone star tick, which transmits both E chaffeensis and E ewingii, is found in the Southeastern, Mid-Atlantic, Midwestern, and South Central United States. A phagocytophilum is transmitted by the black-legged tick, Ixodes scapularis, which is found in the Eastern United States, and by the western black-legged tick, Ixodes pacificus, which is found in the Western United States.

• #41 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Ehrlichiosis and anaplasmosis are emerging infections in the United States and worldwide. In the United States, these infections are the most frequently recorded tick-borne diseases after Lyme disease, with estimated case fatality rates of 2.7% and 0.3%, respectively. The increase in these tick-borne diseases is a public health concern because the tick population is increasing mainly due to climate change. The geographic distribution of ticks is expanding, and more cases are being reported. Efforts to perform surveillance are being used to understand the ecology and distribution of the ticks, their reservoirs, and the endemic areas for infections transmitted through ticks. […] The changing epidemiology of Ehrlichia and the geographical distribution of the reservoir, the white-tailed deer, and the lone star tick depend on many factors. Abiotic factors, such as temperature and humidity, and biotic factors, such as vegetation density and shade, along with climate change, result in warmer temperatures in higher latitudes and can increase the geographic expansion of vectors and reservoirs. Changes in the white-tailed deer populations, for any reason, affect the epidemiology of human monocytic ehrlichiosis.

• #42

  https://scholars.duke.edu/individual/pub1497227

  Ehrlichioses and anaplasmosis have undergone dramatic increases in incidence, and the geographic ranges of their occurrence and vectors have also expanded. […] There is marked underreporting of these diseases owing to deficient physician awareness and knowledge of the illnesses as well as limited access to appropriate diagnostic tests. […] The Ehrlichiosis and Anaplasmosis Subcommittee of the Tick-Borne Disease Working Group recommended active clinical surveillance to determine the true incidence, full clinical spectrum, and risk factors for severe illness, as well as standardized surveillance of ticks for these pathogens, and enhanced education of primary medical caregivers and the public regarding these diseases.

• #43 EPIDEMIOLOGY OF HUMAN EHRLICHIOSIS AND ANAPLASMOSIS IN THE UNITED STATES, 2001–2002 in: The American Journal of Tropical Medicine and Hygiene Volume 73 Issue 2 (2005)

  https://www.ajtmh.org/abstract/journals/tpmd/73/2/article-p400.xml

  During 2001 through 2002, 1,176 cases of the tick-borne diseases human monocytic ehrlichiosis (HME) and human granulocytic anaplasmosis (HGA) were reported to the Centers for Disease Control and Prevention (CDC) by 32 states through the National Electronic Telecommunications System for Surveillance. The average reported annual incidences for HME and HGA during 2001-2002 were 0.6 and 1.4 cases per million population, respectively; incidence was highest among men 60 years of age. […] The surveillance information retrieved from CRFs has allowed for qualitative evaluation of ehrlichiosis and anaplasmosis risk factors, severity, and diagnostic accuracy. […] Although these surveillance systems likely substantially under-represent the true burden of ehrlichiosis and anaplasmosis in the United States due to poor recognition and reporting, they represent the first compilation of national data since these diseases were made nationally notifiable. Continued and improved surveillance activities will progressively reinforce our understanding and awareness of these newly recognized zoonotic infections.

• #44 Ehrlichiosis and anaplasmosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/912

  Ehrlichiosis and anaplasmosis, of all types, are nationally notifiable diseases. […] Seasonality is due to higher likelihood of tick exposure/bite when people spend more time outdoors in warmer months.

• #44 Ehrlichiosis and anaplasmosis – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/912/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis, of all types, are nationally notifiable diseases. […] Seasonality is due to higher likelihood of tick exposure/bite when people spend more time outdoors in warmer months. […] Centers for Disease Control and Prevention. Ehrlichiosis – epidemiology and statistics. May 2024 [internet publication]. […] Centers for Disease Control and Prevention. Anaplasmosis – epidemiology and statistics. May 2024 [internet publication]. […] Increasing incidence of Ehrlichiosis in the United States: a summary of national surveillance of Ehrlichia chaffeensis and Ehrlichia ewingii infections in the United States, 2008-2012. […] Human granulocytic anaplasmosis in the United States from 2008 to 2012: a summary of national surveillance data. […] Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988.

• #45 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #46 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Both infections appear to be more severe and have a higher mortality rate in patients with compromised immunity caused by immunosuppressants (eg, corticosteroids, cancer chemotherapy, long-term treatment with immunosuppressants after organ transplantation), HIV infection, or splenectomy. […] Diagnostic serologic tests are available for ehrlichiosis and anaplasmosis, but PCR of blood is more sensitive and specific and can result in an earlier diagnosis because serologic tests require comparison of serial titers. […] Treatment of ehrlichiosis and anaplasmosis is best started before laboratory results return. […] No vaccine is available to prevent ehrlichiosis or anaplasmosis. […] Ehrlichiosis and anaplasmosis are tick-borne infections related to rickettsial diseases. […] Do PCR testing of blood, which is more sensitive and specific than serologic tests and can result in an early diagnosis. […] Treat with doxycycline, best started before laboratory results return.

• #47 Anaplasmosis and Ehrlichiosis Fact Sheet

  https://www.health.ny.gov/diseases/communicable/ehrlichiosis/fact_sheet.htm

  Anaplasmosis and Ehrlichiosis are two closely related tick-borne bacterial diseases spread by the bite of infected ticks. Anaplasmosis, formerly called human granulocytic ehrlichiosis (HGE), is spread to humans by blacklegged deer ticks infected with the bacterium, Anaplasma phagocytophilia. Ehrlichiosis, or human monocytic ehrlichiosis (HME), is spread to humans by lone star ticks infected with the bacterium, Ehrlichia chaffeensis. In New York State, most cases have been reported on Long Island and in the Hudson Valley. […] Anaplasmosis or Ehrlichiosis can affect people of any age. Neither disease is spread from person to person. People who spend time outdoors hiking, working, or playing, particularly in grassy and wooded areas from April until October are at greatest risk for exposure. Ticks can be active any time the temperature is above freezing.

• #48 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Both infections appear to be more severe and have a higher mortality rate in patients with compromised immunity caused by immunosuppressants (eg, corticosteroids, cancer chemotherapy, long-term treatment with immunosuppressants after organ transplantation), HIV infection, or splenectomy. […] Diagnostic serologic tests are available for ehrlichiosis and anaplasmosis, but PCR of blood is more sensitive and specific and can result in an earlier diagnosis because serologic tests require comparison of serial titers. […] Treatment of ehrlichiosis and anaplasmosis is best started before laboratory results return. […] No vaccine is available to prevent ehrlichiosis or anaplasmosis. […] Ehrlichiosis and anaplasmosis are tick-borne infections related to rickettsial diseases. […] Do PCR testing of blood, which is more sensitive and specific than serologic tests and can result in an early diagnosis. […] Treat with doxycycline, best started before laboratory results return.

• #49 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  The reported incidence of E chaffeensis from 2000 to 2007 increased from 0.80 to 3.0 cases per million persons per year, and the case fatality rate and hospitalization rates were 1.9% and 49%, respectively. From 2008 to 2012, 4613 cases of E chaffeensis and 55 cases of E ewingii were reported through the CDC in the United States. The incidence rate was 3.2 cases per million person-years, the hospitalization rate was 57%, and the case fatality rate was 1%. The highest case fatality rate was 4%, reported in children younger than 5. Until 2012, the rate of ehrlichiosis had increased 4-fold since 2000. […] Symptoms may range from mild to severe and can even be fatal if not treated, especially if infected with E chaffeensis and A phagocytophilum. Patients who are older or immunocompromised may have worse outcomes if not treated promptly. Ehrlichiosis and anaplasmosis can also be transmitted through blood transfusions, which have been increasingly reported, especially in patients with hematological or solid tumor malignancies and transplantation. Cases in adults and children can be mild and subclinical, or clinicians may not consider the disease in the differential diagnosis. Thus, the disease may be underdiagnosed and under-reported.

• #50 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Both infections appear to be more severe and have a higher mortality rate in patients with compromised immunity caused by immunosuppressants (eg, corticosteroids, cancer chemotherapy, long-term treatment with immunosuppressants after organ transplantation), HIV infection, or splenectomy. […] Diagnostic serologic tests are available for ehrlichiosis and anaplasmosis, but PCR of blood is more sensitive and specific and can result in an earlier diagnosis because serologic tests require comparison of serial titers. […] Treatment of ehrlichiosis and anaplasmosis is best started before laboratory results return. […] No vaccine is available to prevent ehrlichiosis or anaplasmosis. […] Ehrlichiosis and anaplasmosis are tick-borne infections related to rickettsial diseases. […] Do PCR testing of blood, which is more sensitive and specific than serologic tests and can result in an early diagnosis. […] Treat with doxycycline, best started before laboratory results return.

• #51 Anaplasmosis and Ehrlichiosis Fact Sheet

  https://www.health.ny.gov/diseases/communicable/ehrlichiosis/fact_sheet.htm

  Symptoms and possible tick bite exposure may cause a health care professional to suspect one of these infections. Laboratory tests confirm diagnosis by seeing if the bacteria or antibodies against the bacteria are present in the person. […] Anaplasmosis and Ehrlichiosis are bacterial infections. Even if successfully treated, a person may become re-infected if bitten later by another infected tick. […] The best prevention to either disease is through awareness. Check after every two to three hours of outdoor activity for ticks on clothing or skin. Brush off any ticks on clothing before skin attachment occurs. With anaplasmosis, if removal of attached ticks occurs within 12 hours the risk of tick-borne infection is minimal. For ehrlichiosis, if removal of attached ticks occurs within 36 hours the risk of tick-borne infection is minimal.

• #52

  https://scholars.duke.edu/individual/pub1497227

  Ehrlichioses and anaplasmosis have undergone dramatic increases in incidence, and the geographic ranges of their occurrence and vectors have also expanded. […] There is marked underreporting of these diseases owing to deficient physician awareness and knowledge of the illnesses as well as limited access to appropriate diagnostic tests. […] The Ehrlichiosis and Anaplasmosis Subcommittee of the Tick-Borne Disease Working Group recommended active clinical surveillance to determine the true incidence, full clinical spectrum, and risk factors for severe illness, as well as standardized surveillance of ticks for these pathogens, and enhanced education of primary medical caregivers and the public regarding these diseases.

• #53 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Ehrlichiosis and anaplasmosis are emerging infections in the United States and worldwide. In the United States, these infections are the most frequently recorded tick-borne diseases after Lyme disease, with estimated case fatality rates of 2.7% and 0.3%, respectively. The increase in these tick-borne diseases is a public health concern because the tick population is increasing mainly due to climate change. The geographic distribution of ticks is expanding, and more cases are being reported. Efforts to perform surveillance are being used to understand the ecology and distribution of the ticks, their reservoirs, and the endemic areas for infections transmitted through ticks. […] The changing epidemiology of Ehrlichia and the geographical distribution of the reservoir, the white-tailed deer, and the lone star tick depend on many factors. Abiotic factors, such as temperature and humidity, and biotic factors, such as vegetation density and shade, along with climate change, result in warmer temperatures in higher latitudes and can increase the geographic expansion of vectors and reservoirs. Changes in the white-tailed deer populations, for any reason, affect the epidemiology of human monocytic ehrlichiosis.

• #54 Undetermined Human Ehrlichiosis and Anaplasmosis in the United States, 2008–2012: A Catch-All for Passive Surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4751933/

  Human ehrlichiosis and anaplasmosis are potentially severe illnesses endemic in the United States. […] The reported incidence rate during this time was 0.52 cases per million person-years. […] Enhanced surveillance in an area where several of these etiologic agents are endemic may provide a better understanding of the epidemiology of ehrlichiosis and anaplasmosis in the United States. […] The discovery of human infections with the EML agent in the Upper Midwest, and with the Panola Mountain Ehrlichia species in Georgia, adds another layer to understanding the epidemiology of ehrlichiosis and anaplasmosis in the United States. […] Human undetermined ehrlichiosis/anaplasmosis remains a useful albeit convoluted notifiable condition in defining the epidemiology of ehrlichiosis and anaplasmosis in the United States.

• #55 Ehrlichiosis: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/235839-overview

  Ehrlichiosis is a seasonal disease observed mainly from April to September. […] In 1999, ehrlichiosis became reportable to the US Centers for Disease Control and Prevention (CDC). […] In 2005, 506 cases of human monocytic ehrlichiosis (HME) were reported. […] A 2011 report identified a new ehrlichia species in 4 patients in the Minnesota and Wisconsin areas. […] Notably, while cases and incidence rose, the case fatality rate (ie, the proportion of patients with ehrlichiosis who died as a result of infection) has declined since 2000, although the case fatality rate in recent publications is still roughly 1% of cases. […] Ehrlichiosis occurs essentially worldwide, and the frequency parallels the distribution of the appropriate tick vectors for the transmission of Ehrlichia bacteria and the mammalian hosts. […] The rates of HME and HGA are higher in males than in females, most likely due to a higher rate of participation in high-risk outdoor activities among males. […] Ehrlichiosis is reported more frequently in adults than in children. The highest age range is between 40 and 64 years.

• #56 Human granulocytic anaplasmosis discovered in the Estrie region of Québec, Canada, 2021, CCDR 48(5) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-5-may-2022/human-granulocytic-anaplasmosis-estrie-quebec.html

  Human granulocytic anaplasmosis (HGA) is a potentially severe tick-borne infection caused by the bacterium Anaplasma phagocytophilum (A. phagocytophilum) of the genus Rickettsia. Here, we describe the epidemiological and clinical characteristics of an unusual cluster of HGA cases detected in the Estrie region in Qubec, Canada, during the 2021 transmission season. […] A total of 25 confirmed cases were identified during the 2021 transmission season, thus constituting the largest known cluster of HGA in Canada. […] Epidemiological investigation found that all cases were domestically acquired, and yard maintenance was the most prevalent at-risk activity identified. […] Detection of this unusual cluster of HGA cases provides further evidence that A. phagocytophilum may now be established along the southern border of Qubec.

• #56 Human granulocytic anaplasmosis discovered in the Estrie region of Québec, Canada, 2021, CCDR 48(5) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-5-may-2022/human-granulocytic-anaplasmosis-estrie-quebec.html

  Our data also provides further evidence that A. phagocytophilum may now be established in blacklegged tick populations in the Estrie region, as previously indicated by acarological surveillance programs. […] Before 2021, only three confirmed cases of human anaplasmosis had been reported to public health in Qubec, including one in the Estrie region. […] A reportable disease status should be considered by provincial and federal jurisdictions, and health promotion efforts that aim to reduce the risk of tick encounters should be reinforced. […] Clinicians should consider the possibility of HGA when assessing patients with fever, leukopenia, thrombocytopenia, elevated hepatic transaminase levels and recent exposure to high-risk environments for tick bites.

• #57 Human granulocytic anaplasmosis discovered in the Estrie region of Québec, Canada, 2021, CCDR 48(5) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-5-may-2022/human-granulocytic-anaplasmosis-estrie-quebec.html

  Our data also provides further evidence that A. phagocytophilum may now be established in blacklegged tick populations in the Estrie region, as previously indicated by acarological surveillance programs. […] Before 2021, only three confirmed cases of human anaplasmosis had been reported to public health in Qubec, including one in the Estrie region. […] A reportable disease status should be considered by provincial and federal jurisdictions, and health promotion efforts that aim to reduce the risk of tick encounters should be reinforced. […] Clinicians should consider the possibility of HGA when assessing patients with fever, leukopenia, thrombocytopenia, elevated hepatic transaminase levels and recent exposure to high-risk environments for tick bites.

• #58 Human granulocytic anaplasmosis discovered in the Estrie region of Québec, Canada, 2021, CCDR 48(5) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2022-48/issue-5-may-2022/human-granulocytic-anaplasmosis-estrie-quebec.html

  Our data also provides further evidence that A. phagocytophilum may now be established in blacklegged tick populations in the Estrie region, as previously indicated by acarological surveillance programs. […] Before 2021, only three confirmed cases of human anaplasmosis had been reported to public health in Qubec, including one in the Estrie region. […] A reportable disease status should be considered by provincial and federal jurisdictions, and health promotion efforts that aim to reduce the risk of tick encounters should be reinforced. […] Clinicians should consider the possibility of HGA when assessing patients with fever, leukopenia, thrombocytopenia, elevated hepatic transaminase levels and recent exposure to high-risk environments for tick bites.

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