Emergence of the Ehrlichioses as Human Health Problems

David Walker, J. Stephen Dumler

Research output: Contribution to journalArticle

266 Citations (Scopus)

Abstract

Ehrlichiae are small, gram-negative, obligately intracellular bacteria that reside within a phagosome. The first human ehrlichial infection was recognized in the United States in 1987. It was later shown to be caused by a new species, Ehrlichia chaffeensis. In 1994, an ehrlichial pathogen within neutrophils that is closely related to the known veterinary pathogens E. equi and E. phagocytophila was found to infect humans. Molecular methods were required to detect, characterize, and identify these fastidious and uncultivated bacteria. Subsequently, E. chaffeensis infection was documented in more than 400 patients in 30 states, Europe, and Africa. Likewise, approximately 170 cases of human granulocytic ehrlichiosis have been diagnosed, most since 1994, predominantly in the upper midwestern and northeastern states, but also in northern California. The disease caused by ehrlichiae is generally undifferentiated but is often associated with leukopenia, thrombocytopenia, and elevated serum hepatic transaminase levels in tick-exposed patients. Infection ranges from subclinical to fatal; tetracycline appears to be an effective therapy. The emergence of these two newly recognized tickborne infections as threats to human health is probably due to increased clinical cognizance, but as in other emerging tickborne infections, it is likely that the rapid increase in identified cases signals a true emergence of disease associated with a changing vector-host ecology.

Original languageEnglish (US)
Pages (from-to)18-29
Number of pages12
JournalEmerging Infectious Diseases
Volume2
Issue number1
StatePublished - Jan 1996

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Ehrlichiosis
Ehrlichia chaffeensis
Ehrlichia
Health
Infection
Bacteria
Phagosomes
Asymptomatic Infections
Leukopenia
Ticks
Transaminases
Tetracycline
Ecology
Thrombocytopenia
Neutrophils
Liver
Serum

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Microbiology (medical)

Cite this

Emergence of the Ehrlichioses as Human Health Problems. / Walker, David; Dumler, J. Stephen.

In: Emerging Infectious Diseases, Vol. 2, No. 1, 01.1996, p. 18-29.

Research output: Contribution to journalArticle

Walker, David ; Dumler, J. Stephen. / Emergence of the Ehrlichioses as Human Health Problems. In: Emerging Infectious Diseases. 1996 ; Vol. 2, No. 1. pp. 18-29.
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