[Human anaplasmosis--a hidden disease in Norway?].
BACKGROUND
Ticks and tick-borne infections will most probably increase in Norway due to global warming, regrowth of pastures and an increasing number of cervids. A. phagocytophilum is already a common infection among domestic ruminants and cervids in tick (Ixodes ricinus) infested areas in Norway.


METHODS
The article provides a review of A. phagocytophilum infection in mammals, with a special focus on human anaplasmosis. It is based on relevant literature and the author's extensive research on this bacterium.


CONCLUSIONS
A. phagocytophilum infection may cause a tick-borne disease. Although the infection is widespread in animals along the coast of southern Norway, only few human cases have been reported so far. This discordance may indicate that physicians are not adequately aware of the disease's existence and that few clinical laboratories offer diagnostic testing of human anaplasmosis and/or infection of humans with low virulent variants of A. phagocytophilum. Even though infection with A. phagocytophilum mainly presents as a influenzae-like disease it may have a fatal outcome. Human anaplasmosis should be considered as a differential diagnosis when faced with a patient with influenzae-like symptoms 1-3 weeks after a tick bite.
Stuen
Snorre
S
Seksjon for småfeforskning, Institutt for produksjonsdyrmedisin, Norges veterinaerhøgskole, 4325 Sandnes. snorre.stuen@veths.no
Bergström
Karin
K
D041081:Anaplasma phagocytophilum / Q000302:isolation & purification / Q000472:pathogenicity; D000712:Anaplasmosis / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D000818:Animals; D003937:Diagnosis, Differential; D016873:Ehrlichiosis / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D009664:Norway / Q000453:epidemiology