The Human Ehrlichioses in the United States
1999

Human Ehrlichioses in the United States

Sample size: 1223 publication Evidence: moderate

Author Information

Author(s): Jennifer H. McQuiston, Christopher D. Paddock, Robert C. Holman, James E. Childs

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

The public health importance of ehrlichioses has not been well defined due to underreporting and variability in state surveillance.

Conclusion

Ehrlichioses are emerging tick-borne diseases in the U.S. with significant underreporting and varying incidence rates across states.

Supporting Evidence

  • From 1986 through 1997, 1,223 cases of ehrlichiosis were reported by state health departments.
  • HME was most commonly reported from southeastern and southcentral states, while HGE was most often reported from northeastern and upper midwestern states.
  • The annual number of reported cases increased sharply from 69 in 1994 to 364 in 1997.
  • Case-fatality ratios were found to be 2.7% for HME and 0.7% for HGE based on available data.
  • Ehrlichiae are susceptible to tetracyclines, allowing for effective treatment.
  • Improved national surveillance is needed to better assess the public health importance of ehrlichiosis.

Takeaway

Ehrlichiosis is a disease you can get from tick bites, and many cases go unreported, making it hard to know how common it really is.

Methodology

Data were collected from state health departments regarding reported cases of ehrlichiosis from 1986 to 1997.

Potential Biases

Some states did not differentiate between probable and confirmed cases, which may affect the accuracy of reported data.

Limitations

The data may underestimate the true prevalence of ehrlichiosis due to incomplete reporting and variability in state surveillance.

Participant Demographics

Data were reported from 30 state health departments across the United States.

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