Serologic evidence for human ehrlichiosis in Africa

Human ehrlichiosis is a recently recognized rickettsial disease. It is caused by Ehrlichia chaffeensis, an intraleucocytic Gram-negative, obligate intracellular bacterium, grouped within the genus Ehrlichiae. Most human cases of ehrlichiosis have been diagnosed in the USA. Two cases have been reported outside of the USA, one in Europe and one in Africa. From 1 January to 30 June 1992, 765 sera from blood donors or other asymptomatic subjects in 8 African countries, including Ivory Coast, Burkina Faso, Mali, Central African Republic, Angola, Zimbabwe, Mozambique and Commores Islands, were tested by indirect immunofluorescence for the presence of E. chaffeensis antibodies. Positive sera were confirmed by Western immunoblotting. Only two of 765 sera tested were positive. One serum obtained from Burkina Faso had an IgG titer of 1:200 and one from Mozambique had an IgG titer of 1:80. Human ehrlichiosis seems to occur infrequently in Africa, although many more sera from additional African countries need to be evaluated.