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Bayesian Spatio-Temporal Analysis and Geospatial Risk Factors of Human Monocytic Ehrlichiosis  [PDF]
Ram K. Raghavan, Daniel Neises, Douglas G. Goodin, Daniel A. Andresen, Roman R. Ganta
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0100850
Abstract: Variations in spatio-temporal patterns of Human Monocytic Ehrlichiosis (HME) infection in the state of Kansas, USA were examined and the relationship between HME relative risk and various environmental, climatic and socio-economic variables were evaluated. HME data used in the study was reported to the Kansas Department of Health and Environment between years 2005–2012, and geospatial variables representing the physical environment [National Land cover/Land use, NASA Moderate Resolution Imaging Spectroradiometer (MODIS)], climate [NASA MODIS, Prediction of Worldwide Renewable Energy (POWER)], and socio-economic conditions (US Census Bureau) were derived from publicly available sources. Following univariate screening of candidate variables using logistic regressions, two Bayesian hierarchical models were fit; a partial spatio-temporal model with random effects and a spatio-temporal interaction term, and a second model that included additional covariate terms. The best fitting model revealed that spatio-temporal autocorrelation in Kansas increased steadily from 2005–2012, and identified poverty status, relative humidity, and an interactive factor, ‘diurnal temperature range x mixed forest area’ as significant county-level risk factors for HME. The identification of significant spatio-temporal pattern and new risk factors are important in the context of HME prevention, for future research in the areas of ecology and evolution of HME, and as well as climate change impacts on tick-borne diseases.
Ehrlichiosis humana: Ehrlichia trombocítica en sangre periférica.
Revista de la Sociedad Venezolana de Microbiología , 2003,
Abstract: ehrlichia is a small obligatory intracellular and gram-negative bacteria that grows within a cytoplastic vacuoles in animals and human blood cells. ehrlichia multiplies by binary fision originating a microcolonies or aggregates named "morulae", visible in blood smear with optic microscope. transmitted by ticks, cause an illness named ehrlichiosis. by 1987, monocytic ehrlichia was described in usa and granulocytotropic ehrlichia by 1994 and 1999. in venezuela, an ehrlichia agent with trombocytotropic characteristic was reported first by 1994 in human blood smear. it is reported the data of a group of subjects that for different reasons asked for the exam. 182 blood smears (peripheral and buffy coat) stained with wright were studied. intraplatelet ehrlichia morulae were identified in 68 of 182 studied subjects (37,36%).
Magnetic Resonance Imaging Lesions in the Central Nervous System of a Dog with Canine Monocytic Ehrlichiosis
Linda G. Lang,John F. Griffin,Jonathan M. Levine,Edward B. Breitschwerdt
Case Reports in Veterinary Medicine , 2011, DOI: 10.1155/2011/379627
Abstract: A ten-year-old neutered male dog was examined for tetraparesis, vestibular dysfunction, ataxia,and vertebral column hyperesthesia of 10 days duration. On magnetic resonance imaging (MRI),there were multifocal, punctate, T2-hyperintense lesions in the brain and cervical spinal cord andintracranial leptomeningeal contrast enhancement. Cerebrospinal fluid (CSF) analysis revealed apredominantly mononuclear pleocytosis and mildly elevated protein. Ehrlichia canis wasdiagnosed by serum immunofluorescent antibody (IFA) testing. The dog improved withadministration of doxycycline. This report describes MRI central nervous system findings in a dogwith ehrlichiosis.
Human ehrlichiosis  [PDF]
?oki? Milomir,?ur?i? Petar,No?i? Darko,Lako Branislav
Vojnosanitetski Pregled , 2006, DOI: 10.2298/vsp0604403d
Abstract: Background. Human ehrlichiosis is a newly recognized disease. It is a tick-borne disease caused by several bacterial species of the genhus Erlichia. These are small gram-negative pleomorphic cocci, that are obligatory intracellular bacteria. Tick Ixodes is the principle vector in Europe, and Amblyomma americanum in the United States. Bacterial organisms replicate in a tick, and are transmited from infected cells in a vector to the blood cells of animals or humans. Human ehrlichiosis is a name for a group of diseases caused by different species of Ehrlichia. One of them is the disease named human monocytic ehrlichiosis, caused by Ehrlichia chaffeensis, and the other is a human granulocytic ehrlichiosis caused by Anaplasma phagocytophilia. Case report. We reported a 23-year-old patient admitted for the clinical treatment with the symptoms of high febrility (above 40 °C), headache, vomiting, general weakness and exhaustion, but without data on a tick bite. The patient was treated with trimetoprim-sulfamethoxazole for a week when Ehrlichia chaffeensis was confirmed by the immunofluoroscence test, and the therapy contimed with doxacyclin. Conclusion. Human ehrlichiosis is also present in our country, so this disease should be considered everyday, especially in infectology practice.
Lymph node hemophagocytosis in rickettsial diseases: a pathogenetic role for CD8 T lymphocytes in human monocytic ehrlichiosis (HME)?
Kerry L Dierberg, J Stephen Dumler
BMC Infectious Diseases , 2006, DOI: 10.1186/1471-2334-6-121
Abstract: To study histopathologic responses in the lymphatic system for correlates of immune injury, lymph nodes from patients with HME (n = 6) and RMSF (n = 5) were examined. H&E-stained lymph node tissues were examined for five histopathologic features, including hemophagocytosis, cellularity, necrosis, and vascular congestion and edema. The relative proportions of CD68 macrophages, CD8 and CD4 T lymphocytes, and CD20 B lymphocytes were evaluated by immunohistochemical staining.Hemophagocytosis was similar in HME and RMSF, and was greater than in control cases (p = .015). Cellularity in HME was not different from controls, whereas RMSF lymph nodes were markedly less cellular (p < 0.002). E. chaffeensis-infected mononuclear phagocytes were infrequent compared to R. rickettsii-infected endothelial cells. More CD8 cells in lymph nodes were observed with HME (p < .001), but no quantitative differences in CD4 lymphocytes, macrophages, or B lymphocytes were identified.Hemophagocytosis, CD8 T cell expansion, and the paucity of infected cells in HME, suggest that E. chaffeensis infection leads to macrophage activation and immune-mediated injury.The tick-borne obligate intracellular bacteria Ehrlichia chaffeensis and Rickettsia rickettsii are the causes of human monocytic ehrlichiosis (HME) and Rocky Mountain spotted fever (RMSF) diseases, respectively [1]. E. chaffeensis is transmitted by the Lone Star tick, Amblyomma americanum, and human infection typically presents with fever, myalgias, pancytopenia, and mild to moderate elevation of serum transaminases [2]. This clinical presentation is easily confused with that of RMSF, which typically presents with fever, rash, and headache. R. rickettsii is known to infect endothelial cells, leading to direct rickettsia-mediated vascular injury accompanied by a vigorous but protective Th1 immune response [3]. E. chaffeensis is known to infect cells in the monocyte/macrophage lineage, but the pathogenesis of HME is less clear [4]. Lymphohist
Ehrlichiosis in Brazil
Vieira, Rafael Felipe da Costa;Biondo, Alexander Welker;Guimar?es, Ana Marcia Sá;Santos, Andrea Pires dos;Santos, Rodrigo Pires dos;Dutra, Leonardo Hermes;Diniz, Pedro Paulo Vissotto de Paiva;Morais, Helio Autran de;Messick, Joanne Belle;Labruna, Marcelo Bahia;Vidotto, Odilon;
Revista Brasileira de Parasitologia Veterinária , 2011, DOI: 10.1590/S1984-29612011000100002
Abstract: ehrlichiosis is a disease caused by rickettsial organisms belonging to the genus ehrlichia. in brazil, molecular and serological studies have evaluated the occurrence of ehrlichia species in dogs, cats, wild animals and humans. ehrlichia canis is the main species found in dogs in brazil, although e. ewingii infection has been recently suspected in five dogs. ehrlichia chaffeensis dna has been detected and characterized in mash deer, whereas e. muris and e. ruminantium have not yet been identified in brazil. canine monocytic ehrlichiosis caused by e. canis appears to be highly endemic in several regions of brazil, however prevalence data are not available for several regions. ehrlichia canis dna also has been detected and molecularly characterized in three domestic cats, and antibodies against e. canis were detected in free-ranging neotropical felids. there is serological evidence suggesting the occurrence of human ehrlichiosis in brazil but its etiologic agent has not yet been established. improved molecular diagnostic resources for laboratory testing will allow better identification and characterization of ehrlichial organisms associated with human ehrlichiosis in brazil.
Tick-borne ehrlichiosis infection in human beings  [PDF]
S. Ganguly,S.K. Mukhopadhayay
Journal of Vector Borne Diseases , 2008,
Abstract: Human monocytic ehrlichiosis is a tick-borne infectious disease transmitted by several tick species, especially Amblyomma spp caused by Ehrlichia chaffeensis. E. chaffeensis is an obligatory intracellular, tick-transmitted bacterium that is maintained in nature in a cycle involving at least one and perhaps several vertebrate reservoir hosts. Two additional Ehrlichia spp, Anaplasma (formerly Ehrlichia) phagocytophila (the agent of human granulocytic ehrlichiosis [HGE]) and E. ewingii (a cause of granulocytic ehrlichiosis in dogs) act as human pathogens. Human E. chaffeensis infections have generally been reported in North America, Asia and Europe, but recently human cases have been reported in Brazil only. Human monocytic ehrlichiosis is diagnosed by demonstration of a four-fold or greater change in antibody titer to E. chaffeensis antigen by IFA in paired serum samples, or a positive PCR assay and confirmation of E. chaffeensis DNA, or identification of morulae in leukocytes and a positive IFA titer to E. chaffeensis antigen, or immunostaining of E. chaffeensis antigen in a biopsy or autopsy sample, or culture of E. chaffeensis from a clinical specimen.
Detection of A. phagocytophilum and E. chaffeensis in Patient and Mouse Blood and Ticks by a Duplex Real-Time PCR Assay  [PDF]
Tuo Dong, Zhangyi Qu, Lijuan Zhang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0074796
Abstract: Human granulocytic anaplasmosis (HGA) and human monocytic ehrlichiosis (HME) are emerging, tick-borne, zoonotic infectious diseases caused by Anaplasma phagocytophilum and Ehrlichia chaffeensis, respectively. Early diagnosis is essential for rapid clinical treatment to avoid misdiagnosis and severe patient outcomes. Simple, sensitive and reliable diagnostic methods are urgently needed. In this study, we developed a duplex real-time PCR assay targeting the A. phagocytophilum ankA gene and the E. chaffeensis TRP120 gene, respectively. The lowest limit of detection of the duplex real-time PCR assay was 100 copies of the targeted A. phagocytophilum ankA gene and the E. chaffeensis TRP120 gene per reaction, and the specificity was 100%. Detection in blood DNA samples from the acute stage of illness for 22 HGA cases and 8 HME cases indicated that the duplex real-time PCR assay was more sensitive than the nested PCR assay. The infection of Citellus undulatus Pallas with A. phagocytophilum and E. chaffeensis was first confirmed in Xinjiang Province and the positive rate was 3.1% for A. phagocytophilum, 6.3% for E. chaffeensis and 3.1% for co-infection with both pathogens. The rates of A. phagocytophilum and E. chaffeensis infection of D. silvarum ticks collected from Shanxi Province were 8.2% and 14.8%, respectively, and the co-infection rate was 3.3%. The rates of A. phagocytophilum and E. chaffeensis infection in H. longicornis ticks collected from Shandong Province were 1.6% and 6.3%, respectively, and the co-infection rate was 1.6%.
Ehrlichia canis and Anaplasma platys in ticks of dogs in Cuiaba, Mato Grosso Ehrlichia canis e Anaplasma platys em carrapatos de c es de Cuiabá, Mato Grosso  [cached]
Arleana do Bom Parto Ferreira de Almeida,Daphine Ariadne Jesus de Paula,Magyda Arabia Araji Dahroug,Agrádia Gon?alves de Freitas
Semina : Ciências Agrárias , 2012,
Abstract: Diseases transmitted by arthropods such as Rhipicephalus sanguineus, are caused by a spectrum of pathogens. Among these are the canine monocytic ehrlichiosis and cyclical thrombocytopenia with a cosmopolitan distribution. Aiming to verify the presence of DNA of Anaplasma platys and Ehrlichia canis in ticks R. sanguineus collected in the period 2008 to 2009 of 380 infected dogs. Ticks, after maceration, were subjected to DNA extraction and then nested PCR was performed for amplification of A. platys and E. canis. Of these, 81 (29.7%) amplified DNA from ehrlichiais agents, where 38 (17.9%) amplified in E. canis and 32 (15.7%) for A. platys. The observation of two pathogens, combined with worldwide distribution of the tick R. sanguineus, demonstrates the high risk of infection with these pathogens in dogs in the city of Cuiaba. Doen as transmitidas por artrópodes, como o Rhipicephalus sanguineus, s o causadas por um espectro de patógenos. Dentre estas, est o a erliquiose monocítica canina e trombocitopenia cíclica com distribui o cosmopolita. Com o objetivo de verificar a presen a de DNA de Anaplasma platys e Ehrlichia canis em carrapatos R. sanguineus coletados no período de 2008 a 2009 de 380 c es infestados. Os carrapatos, após a macera o, foram submetidos a extra o de DNA e, em seguida, foi realizada a Nested PCR para a amplifica o da espécie A. platys e E. canis. Destes, 81 (29.7%) amplificaram o DNA dos agentes ehrlichiais, onde 38 (17.9%) amplificaram para E. canis e 32 (15.7%) para A. platys. A observa o dos dois patógenos, combinado com distribui o mundial do carrapato R. sanguineus, demonstra o elevado risco de infec o por esses patógenos de c es na cidade de Cuiabá.
Perfil clínico-laboratorial da erliquiose monocítica canina em c es de Salvador e regi o metropolitana, Bahia Clinical and laboratorial profile of canine anine monocytic onocytic ehrlichiosis hrlichiosis of dogs from Salvador and metropolitan region of Bahia State State, Brazil  [cached]
Iris Daniela Santos de Meneses,Bárbara Maria Paraná da Silva Souza,Carla Maria Moreira Teixeira,José Eugênio Guimar?es
Revista Brasileira de Saúde e Produ??o Animal , 2008,
Abstract: Este trabalho foi realizado com o objetivo de tra ar o perfil clínico e laboratorial para o diagnóstico da erliquiose canina. Utilizaram-se 75 c es, de ambos os sexos, diferentes idades e ra as, da cidade de Salvador e regi o metropolitana, Bahia, incluídos na pesquisa a partir da suspeita clínica e por apresentar infesta o de carrapatos ou histórico de exposi o prévia ao vetor. Anticorpos anti-Ehrlichia canis foram encontrados em 98,66% (74/75) dos animais. A PCR foi positiva em 33,3% (25/75) dos c es, enquanto a presen a de mórulas foi positiva em 5,33% (4/75) dos suspeitos. Nos animais com PCR (Rea o da Polimerase em Cadeia) positivo, febre, desidrata o, mucosas hipocoradas e petéquias em membranas mucosas ou na pele e anemia, leucopenia, neutropenia, eosinopenia, linfopenia e trombocitopenia foram os sinais clínicos e laboratoriais estatisticamente significantes (p<0,05) mais freqüentemente encontrados. Canine Ehrlichiosis despite its high morbidy is an illness of great importance in the medical clinic of small animals. The great difficulty for the definitive diagnosis of this disease consists of the little use of more sensible and specific tests considering the clinical signals and more frequent hematological results as exclusive of the illness. This research aimed to provide the clinical-laboratorial profile in the diagnosis of canine ehrlichiosis of 75 dogs, of both sexes, at different ages and races, from Salvador and metropolitan region, Bahia state. The evaluated animals were dogs with clinical suspicion of Ehrlichiosis and tick infestation or description of previous exposition to that vector. Antibodies anti- E. canis were found in 98.66% (74/75) of the animals. The PCR was positive in 33.3% (25/75) of the dogs, while the presence of inclusions (morulae) was observed in 5.33% (4/75) of the suspected animals. Fever, dehydration, pale mucous membranes, petechiae of skin and mucous membranes; and anemia, leucopoenia, neutropenia, eosinopenia, lymphopenia, and thrombocytopenia were the most significant (p<0.05) clinical and laboratory indicators found in animals with positive PCR.
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