title: Human Infection with Ehrlichia muris-like Pathogen, United States, 2007-2013(1).
abstract: An Ehrlichia muris-like (EML) pathogen was detected among 4 patients in Minnesota and Wisconsin during 2009. We characterized additional cases clinically and epidemiologically. During 2004-2013, blood samples from 75,077 patients from all 50 United States were tested by PCR from the groEL gene for Ehrlichia spp. and Anaplasma phagocytophilum. During 2007-2013, samples from 69 (0.1%) patients were positive for the EML pathogen; patients were from 5 states: Indiana (1), Michigan (1), Minnesota (33), North Dakota (3), and Wisconsin (31). Most (64%) patients were male; median age was 63 (range 15-94) years; and all 69 patients reported likely tick exposure in Minnesota or Wisconsin. Fever, malaise, thrombocytopenia, and lymphopenia were the most common symptoms. Sixteen (23%) patients were hospitalized (median 4 days); all recovered, and 96% received doxycycline. Infection with the EML pathogen should be considered for persons reporting tick exposure in Minnesota or Wisconsin.
authors.forename: Diep K Hoang
authors.initials: DK
authors.lastname: Johnson
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Schiffman
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Davis
authors.forename: David F
authors.initials: DF
authors.lastname: Neitzel
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Sloan
authors.forename: William L
authors.initials: WL
authors.lastname: Nicholson
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Fritsche
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Steward
authors.forename: Julie A
authors.initials: JA
authors.lastname: Ray
authors.forename: Tracy K
authors.initials: TK
authors.lastname: Miller
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Feist
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Uphoff
authors.forename: Joni J
authors.initials: JJ
authors.lastname: Franson
authors.forename: Amy L
authors.initials: AL
authors.lastname: Livermore
authors.forename: Alecia K
authors.initials: AK
authors.lastname: Deedon
authors.forename: Elitza S
authors.initials: ES
authors.lastname: Theel
authors.forename: Bobbi S
authors.initials: BS
authors.lastname: Pritt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D041081:Anaplasma phagocytophilum / Q000235:genetics / Q000472:pathogenicity*; D000710:Anaplasmataceae / Q000235:genetics / Q000472:pathogenicity*; D000818:Animals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D012698:Serologic Tests / Q000379:methods*; D013987:Ticks / Q000469:parasitology*; D014922:Wisconsin / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology* / Q000635:transmission / Q000821:virology
keywords: Ehrlichia muris; Ixodes scapularis; United States; bacteria; ehrlichiosis; epidemiology; surveillance; tickborne infections; vector-borne infections; zoonoses