Human Granulocytic Ehrlichiosis in Massachusetts
Authors: Sam R. Telford
Journal: Annals of Internal Medicine (1995)

Brief Communications15 August 1995Human Granulocytic Ehrlichiosis in MassachusettsSam R. Telford, Timothy J. Lepore, Patricia Snow, Cynthia K. Warner, and Jacqueline E. DawsonSam R. TelfordFrom Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia., Timothy J. LeporeFrom Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia., Patricia SnowFrom Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia., Cynthia K. WarnerFrom Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia., and Jacqueline E. DawsonFrom Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-4-199508150-00006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Two new tick-borne zoonoses have recently emerged as threats to public health in North America. Both are caused by infection with Ehrlichia species, obligate intracellular bacteria that localize within the phagosomes of leukocytes. The spectrum of illness varies from mild to severe; about one third of patients require hospitalization. Persons exposed to ticks may present with a "spotless spotted fever" or a disease similar to Lyme disease that does not feature erythema and is accompanied by fever, chills, severe headache, myalgia, malaise, and nausea. A maculopapular or petechial rash, however, may be present [1, 2]. Laboratory findings include thrombocytopenia, leukopenia, ...References1. Fishbein DB, Kemp A, Dawson JE, Greene NR, Redus MA, Fields DH. Human ehrlichiosis: prospective active surveillance in febrile hospitalized patients. J Infect Dis. 1989; 160:803-9. Google Scholar2. Fishbein DB, Dawson JE, Robinson LE. Human ehrlichiosis in the United States, 1985 to 1990. Ann Intern Med. 1994; 120:736-43. Google Scholar3. Donatien A, Lestoquard F. Existence in Algerie d'une rickettsia du chien. Bull Soc Pathol Exot. 1935; 28:418-9. Google Scholar4. Misao T, Kobayashi Y. Studies on infectious mononucleosis (glandular fever). I. Isolation of the etiologic agent from blood, bone marrow, and lymph node of a patient with infectious mononucleosis by using mice. Kyushu J Med Sci. 1955; 6:145-52. Google Scholar5. Maeda K, Markowitz N, Hawley RC, Ristic M, Cox D, McDade JE. Human infection with Ehrlichia canis, a leukocytic rickettsia. 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Prevalence of antibody to Ehrlichia chaffeensis in residents of a Massachusetts Lyme disease focus (Abstract). Program and Abstracts of the 41st Annual Meeting of the American Society of Tropical Medicine and Hygiene. Am J Trop Med Hyg. 1992; 47:249. Google Scholar17. Rich SM, Caporale DA, Telford SR III, Kocher TD, Hartl DL, Spielman A. Distribution of the Ixodes ricinus-like ticks of eastern North America. Proc Natl Acad Sci U S A. 1995; (In press). Google Scholar18. Pancholi P, Kolbert CP, Mitchell P, Reed K, Dumler SJ, Bakken JS, et al. Ixodes dammini as a potential vector of human granulocytic ehrlichiosis. J Infect Dis. (In press). Google Scholar Author, Article, and Disclosure InformationAuthors: Sam R. Telford; Timothy J. Lepore; Patricia Snow; Cynthia K. Warner; Jacqueline E. DawsonAffiliations: From Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia.Corresponding Author: Sam R. Telford III, DSc, Department of Tropical Public Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.Acknowledgments: The authors thank R.E. Corstvet for supplying antigen slides, and Vanesa Baker for technical assistance.Grant Support: By National Institutes of Health grant AI19693, Smith Kline Beecham Pharmaceuticals, the Chace Fund, and the Gibson Island Corporation. 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