Volume 68, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A total of 1,345 ticks collected from northeastern China were investigated for the presence of and by a nested polymerase chain reaction (PCR). Sixty-two (4.6%) ticks were positive for and 454 (33.8%) were positive for . Seven (0.5%) were coinfected with both agents. Sequence analysis of 919-basepair PCR amplicons revealed three types of . Type 1 was identical to the published sequences of s responsible for human granulocytic ehrlichiosis (HGE). The other two variants differed from the HGE agent sequence at one and four positions, respectively. These findings imply that infection with poses a potential health threat to both humans and animals in northeastern China, and that ehrlichiosis should be considered in the differential diagnosis of febrile patients with a history of tick bite, particularly when clinical manifestations are atypical for Lyme disease.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Bakken JS, Dumler JS, Chen SM, Eckman MR, Van Etta LL, Walker DH, 1994. Human granulocytic ehrlichiosis in the upper midwest United States. A new species emerging? JAMA 272 : 212–218. [Google Scholar]
  2. Bakken JS, Krueth J, Wilson-Nordskog C, Tilden RL, Asanovich K, Dumler JS, 1996. Clinical and laboratory characteristics of human granulocytic ehrlichiosis. JAMA 275 : 199–205. [Google Scholar]
  3. Walker DH, Dumler JS, 1996. Emergence of the ehrlichioses as human health problems. Emerg Infect Dis 2 : 18–29. [Google Scholar]
  4. Chen SM, Dumler JS, Bakken JS, Walker DH, 1994. Identification of a granulocytotropic Ehrlichia species as the etiologic agent of human disease. J Clin Microbiol 32 : 589–595. [Google Scholar]
  5. Dumler JS, Barbet AF, Bekker CP, Dasch GA, Palmer GH, Ray SC, Rikihisa Y, Rurangirwa FR, 2001. Reorganization of genera in the families Rickettsiaceae and Anaplasmataceae in the order Rickettsiales: unification of some species of Ehrlichia with Anaplasma, Cowdria with Ehrlichia and Ehrlichia with Neorickettsia, descriptions of six new species combinations and designation of Ehrlichia equi and ‘HGE agent’ as subjective synonyms of Ehrlichia phagocytophila. Int J Syst Evol Microbiol 51 : 2145–2165. [Google Scholar]
  6. Magnarelli LA, Stafford KC III, Mather TN, Yeh MT, Horn KD, Dumler JS, 1995. Hemocytic rickettsia-like organisms in ticks: serologic reactivity with antisera to ehrlichiae and detection of DNA of agent of human granulocytic ehrlichiosis by PCR. J Clin Microbiol 33 : 2710–2714. [Google Scholar]
  7. Pancholi P, Kolbert CP, Mitchell PD, Reed KD, Dumler JS, Bakken JS, Telford SR, Persing DH, 1995. Ixodes dammini as a potential vector of human granulocytic ehrlichiosis. J Infect Dis 72 : 1007–1012. [Google Scholar]
  8. Barlough JE, Madigan JE, Kramer VL, Clover JR, Hui LT, Webb JP, Vredevoe LK, 1997. Ehrlichia phagocytophila genogroup rickettsiae in ixodid ticks from California collected in 1995 and 1996. J Clin Microbiol 35 : 2018–2021. [Google Scholar]
  9. Kramer VL, Randolph MP, Hui LT, Irwin WE, Gutierrez AG, Vugia DJ, 1999. Detection of the agents of human ehrlichioses in ixodid ticks from California. Am J Trop Med Hyg 60 : 62–65. [Google Scholar]
  10. Gug E, Tasker S, Joynson DHM, 1998. Detection of the agent of human granulocytic ehrlichiosis (HGE) in UK ticks using polymerase chain reaction. Epidemiol Infect 21 : 681–683. [Google Scholar]
  11. Pusterla N, Leutenegger CM, Huder JB, Weber R, Braun U, Lutz H, 1999. Evidence of the human granulocytic ehrlichiosis agent in Ixodes ricinus ticks in Switzerland. J Clin Microbiol 37 : 1332–1334. [Google Scholar]
  12. Cao W-C, Zhao Q-M, Zhang P-H, Dumler JS, Zhang X-T, Fang L-Q, Yang H, 2000. Granulocytic ehrlichiae in Ixodes persulcatus ticks from an area in China where Lyme disease is endemic. J Clin Microbiol 38 : 4208–4210. [Google Scholar]
  13. Baumgarten BU, Röllinghoff M, Bogdan C, 1999. Prevalence of Borrelia burgdorferi and granulocytic and monocytic ehrlichiae in Ixodes ricinus ticks from southern Germany. J Clin Microbiol 37 : 3448–3451. [Google Scholar]
  14. Leutenegger CM, Pusterla N, Mislin CN, Weber R, Lutz H, 1999. Molecular evidence of coinfection of ticks with Borrelia burgdorferi sensu lato and the human granulocytic ehrlichiosis agent in Switzerland. J Clin Microbiol 37 : 3390–3391. [Google Scholar]
  15. Schouls LM, van de Pol I, Rijpkema SGT, Schot CS, 1999. Detection and identification of Ehrlichia, Borrelia burgdorferi sensu lato, and Bartonella species in Dutch Ixodes ricinus ticks. J Clin Microbiol 37 : 2215–2222. [Google Scholar]
  16. Christova I, Schouls L, Van de Pol I, Park J, Panayotov S, Lefterova V, Kantardjiev T, Dumler DS, 2001. High prevalence of granulocytic ehrlichiae and Borrelia burgdorferi snesu lato in Ixodes ricinus ticks from Bulgaria. J Clin Microbiol 39 : 4172–4174. [Google Scholar]
  17. Ai CX, Zhang WF, Zhao JH, 1994. Sero-epidemiology of Lyme disease in an endemic area in China. Microbiol Immunol 38 : 505–509. [Google Scholar]
  18. Takada N, Fubito I, Fajita H, Wang H-P, Wang J-C, Masuzawa T, 1998. Lyme disease spirochetes in ticks from northeastern China. J Parasitol 84 : 499–504. [Google Scholar]
  19. Cao W-C, Gao Y-M, Zhang P-H, Zhang X-T, Dai Q-H, Dumler JS, Fang L-Q, Yang H, 2000. Identification of Ehrlichia chaffeensis by nested PCR in ticks from southern China. J Clin Microbiol 38 : 2778–2780. [Google Scholar]
  20. Massung RF, Slater K, Owens JH, Nicholson WL, Mather TN, Solberg VB, Olson JG, 1998. Nested PCR assay for detection of granulocytic ehrlichiae. J Clin Microbiol 36 : 1090–1095. [Google Scholar]
  21. Vasiliu V, Herzer P, Rossler D, Lehnert G, Wilske B, 1998. Heterogeneity of Borrelia burgdorferi sensu lato demonstrated by an Osp-A-type-specific PCR in synovial fluid from patients with Lyme arthritis. Med Microbiol Immunol (Berl) 187 : 97–102. [Google Scholar]
  22. Barlough JE, Madigan JE, Turoff DR, Clover JR, Shelly SM, Dumler JS, 1997. An Ehrlichia strain from a llama (Lama glama) and llama-associated ticks (Ixodes pacificus). J Clin Microbiol 35 : 1005–1007. [Google Scholar]
  23. Von Stedingk LV, Gürtelschmid M, Hanson HS, Gustafson R, Dotevall L, Olsson Engvall E, Granström M, 1997. The human granulocytic ehrlichiosis (HGE) agent in Swedish ticks. Clin Microbiol Infect 3 : 573–574. [Google Scholar]
  24. Jenkins A, Kristiansen B-E, Allum A-G, Aakre RK, Srand L, Kleveland EJ, Van De Pol I, Schouls L, 2001. Borrelia burgdorferi sensu lato and ehrlichia spp. in Ixodes ticks from southern Norway. J Clin Microbiol 39 : 3666–3671. [Google Scholar]
  25. Alekseev AN, Dubinina HV, van de Pol, I, Schouls LM, 2001. Identification of Ehrlichia spp. and Borrelia burgdorferi in Ixodes ticks in the Baltic regions of Russia. J Clin Microbiol 39 : 2237–2242. [Google Scholar]
  26. Fingerle V, Munderloh UG, Liegl G, Wilske B, 1999. Coexistence of ehrlichiae of the phagocytophila group with Borrelia burgdorferi in Ixodes ricinus from southern Germany. Med Microbiol Immunol 188 : 145–149. [Google Scholar]
  27. Duffy J, Pittlekow MR, Kolbert CP, Rutledge BJ, Persing DH, 1997. Coinfection with Borrelia burgdorferi and the agent of human granulocytic ehrlichiosis (letter). Lancet 349 : 399. [Google Scholar]
  28. Nadelman RB, Horowitz HW, Hsieh T-C, Wu JM, Aguero-Rosenfeld ME, Schwartz I, Nowakowski J, Varde S, Wormser GP, 1997. Simultaneous human granulocytic ehrlichiosis and Lyme borreliosis. N Engl J Med 337 : 27–30. [Google Scholar]
  29. Weber R, Pusterla N, Loy M, Lutz H, 1998. Fever, leukopenia, and thrombocytopenia in a patient with acute Lyme borreliosis were due to human granulocytic ehrlichiosis. Clin Infect Dis 26 : 253–254. [Google Scholar]
  30. Drebot MA, Lindsay R, Barker IK, Artsob H, 2001. Characterization of a human granulocytic ehrlichiosis-like agent from Ixodes scapularis, Ontario, Canada. Emerg Infect Dis 7 : 479–480. [Google Scholar]
  31. Anderson BE, Dawson J E, Jones DC, Wilson KH, 1991. Ehrlichia chaffeensis, a new species associated with human ehrlichiosis. J Clin Microbiol 29 : 2838–2842 [Google Scholar]

Data & Media loading...

  • Received : 20 Jun 2002
  • Accepted : 03 Jan 2003

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error