title: Human Granulocytic Ehrlichiosis in Belgium: an underestimated cause of disease.
abstract: OBJECTIVE
  Human Granulocytic Ehrlichiosis (HGE) is a recently discovered zoonosis and, in Europe, not always included in laboratory testing when a patient presents with a history of tick bite. The available serology results indicate that HGE should be included in the screening panel when a tick-borne disease is suspected.
  
  
  METHODS
  Serological methods were applied; i.e. indirect immunofluorescence and Western Blot analysis. Sixty-five serum samples from 47 patients were analysed, of six patients sequential samples were available.
  
  
  RESULTS
  33.8% of the submitted samples were found positive in indirect immunofluorescence, Western Blot confirmed 46.1% of these positive samples.
  
  
  CONCLUSIONS
  Although the causative agent and the vector for HGE, Ixodes ticks, are present in Belgium, serology for HGE is seldom solicited. Ehrlichiosis is apparently not always considered as a plausible or possible cause for illness, even when the patient presents with a history of tick bite. We present here a, true be it, incomplete picture of the present situation in Belgium, but nevertheless indicating that it is warranted to test patients with a history of tick bite not only for Lyme disease, but also for HGE.
authors.affiliation: Research Laboratory for Vector-borne Diseases, Queen Astrid Military Hospital, Bruynstraat 1, Brussels B-1120, Belgium. paul.heyman@smd.be
authors.forename: P
authors.initials: P
authors.lastname: Heyman
authors.forename: C
authors.initials: C
authors.lastname: Cochez
authors.forename: G
authors.initials: G
authors.lastname: Bigaignon
authors.forename: B
authors.initials: B
authors.lastname: Guillaume
authors.forename: M
authors.initials: M
authors.lastname: Zizi
authors.forename: C
authors.initials: C
authors.lastname: Vandenvelde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001530:Belgium / Q000453:epidemiology; D015153:Blotting, Western; D002648:Child; D016873:Ehrlichiosis / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006098:Granulocytes / Q000382:microbiology; D006801:Humans; D018884:Ixodes / Q000382:microbiology; D008193:Lyme Disease / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies