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Chapter 15 : Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii

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Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, Page 1 of 2

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Abstract:

At least three species of tick-borne bacteria in the genera ( and ) and () cause moderately severe to life-threatening infections in humans, and they are collectively termed human ehrlichioses. In addition, was recently isolated from a patient without clinical signs of illness; the role of this pathogen as a cause of human disease remains incompletely defined. In this chapter, an understanding of the epidemiology and ecology of and characterization of the disease it causes are relatively nascent. Areas for future investigation in the natural history of include field investigations that define roles of tick species other than and vertebrate hosts other than dogs and deer. Understanding the frequency and mechanism of asymptomatic canine infection may provide insights to the pathogenesis of infections in natural and non-natural hosts. Prospective active surveillance is needed to better identify (i) the numbers of cases of disease in humans caused by , (ii) the geographical distribution of disease in humans, and (iii) the spectrum of clinical disease in various human cohorts. More robust laboratory techniques need to be developed, including methods to isolate in cell culture and serological techniques to distinguish this infection from human monocytic ehrlichiosis. It is likely that other tick-borne ehrlichiae will be recognized eventually as additional agents of human ehrlichioses around the world. The key to identifying novel agents lies in the perspicacity of, and cooperation among, clinicians, veterinarians, epidemiologists, and laboratorians.

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
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Figure 1

Electron micrograph of a canine neutrophil infected by (uranyl acetate-lead citrate stain). This image is provided courtesy of D. A. Kinden and S. L. Stockham ( ); it is reprinted with permission from .

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
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Figure 2

Representative distribution of in 2003 in the United States as determined by PCR assay detection of the agent in deer, dogs, and ticks (shaded) and in human patients (cross-hatched). The actual distribution of the pathogen is likely to include many additional states within the range of the vector tick, (data from references , and ).

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
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References

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Tables

Generic image for table
Table 1

Comparison of prevalences of infection with and in various animal and human cohorts evaluated by PCR assays for both agents

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
Generic image for table
Table 2

Selected epidemiologic characteristics of tick-exposed patients with ehrlichiosis caused by , 1996–2001

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
Generic image for table
Table 3

Selected clinical manifestations of patients infected with or

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15
Generic image for table
Table 4

Selected laboratory findings in patients infected with or

Citation: Paddock C, Liddell A, Storch G. 2005. Other Causes of Tick-Borne Ehrlichioses, Including Ehrlichia ewingii, p 258-267. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch15

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