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The human ehrlichioses in the United States.

J H McQuiston1, C D Paddock, R C Holman

  • 1Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.

Emerging Infectious Diseases
|October 8, 1999
PubMed
Summary

Tick-borne ehrlichiosis, including human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE), is underreported in the US. Surveillance improved, leading to a sharp increase in reported cases from 1994 to 1997.

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Area of Science:

  • Zoonotic diseases
  • Epidemiology
  • Tick-borne illnesses

Background:

  • Human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) are emerging tick-borne zoonoses.
  • These diseases are suspected to be underreported in the United States.

Purpose of the Study:

  • To assess the trends and geographic distribution of HME and HGE in the US.
  • To highlight the impact of improved surveillance on case reporting.

Main Methods:

  • Analysis of reported cases from state health departments (1986-1997).
  • Review of serologic diagnoses from the Centers for Disease Control and Prevention (CDC).

Main Results:

  • A total of 1,223 cases were reported between 1986 and 1997 (742 HME, 449 HGE).

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  • HME was prevalent in southeastern and southcentral states; HGE in northeastern and upper midwestern states.
  • Reported cases surged from 69 in 1994 to 364 in 1997, coinciding with increased state notifiability.

    • Conclusions:

    • Ehrlichiosis reporting has increased, but underreporting likely persists.
    • Enhanced national surveillance is crucial for accurately assessing the public health burden of ehrlichiosis.