Chapter 14 : Human Monocytotropic Ehrlichiosis

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This chapter first gives a brief history of human monocytotropic ehrlichiosis (HME), which is a zoonotic disease. From this brief history of HME, it is clear that rapid progress in understanding this newly emerged tick-borne zoonosis was facilitated both by its successful cultivation and by experimental studies of ticks linked to field observations. Epidemiological studies were furthered through the use of molecular techniques, and knowledge of HME expanded rapidly in the early to mid-1990s. Next, the chapter talks about biology of the etiologic agent. In the eastern United States, is maintained in an epizootic cycle involving the lone star tick () as the principal vector and the white-tailed deer () as a major vertebrate reservoir. This critical vector-host association places these two species at the core of epizootiology and strongly influences its geographic distribution and seasonality of transmission. HME caused by is endemic to the United States, with residents in the southeastern and south-central states at highest risk. The clinical recognition of HME can be difficult, since the spectrum of manifestations is broad and nonspecific, ranging from asymptomatic infection to mild self-limited symptoms to rapidly fatal disease. HME typically presents as an uncomplicated, acute, nonspecific febrile illness that resolves rapidly if treated with doxycycline, characteristic of many rickettsial infections. The chapter ends with a discussion on laboratory diagnosis, treatment and prevention of HME.

Citation: Dawson J, Ewing S, Davidson W, Childs J, Little S, Standaert S. 2005. Human Monocytotropic Ehrlichiosis, p 239-257. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch14

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Figure 1

Electron micrograph of in the cytoplasm of a macrophage. Photograph appears courtesy of Cynthia Goldsmith (CDC).

Citation: Dawson J, Ewing S, Davidson W, Childs J, Little S, Standaert S. 2005. Human Monocytotropic Ehrlichiosis, p 239-257. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch14
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Image of Figure 2
Figure 2

Average annual incidence of HME through 2001, as derived from states reporting cases. The legend indicates incidence values stratified into quartiles.

Citation: Dawson J, Ewing S, Davidson W, Childs J, Little S, Standaert S. 2005. Human Monocytotropic Ehrlichiosis, p 239-257. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch14
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Figure 3

(a) The average age-specific incidence of HME derived from states reporting cases; (b) month of onset for HME.

Citation: Dawson J, Ewing S, Davidson W, Childs J, Little S, Standaert S. 2005. Human Monocytotropic Ehrlichiosis, p 239-257. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch14
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