Maeda K, Markowitz N, Hawley RC, Ristic M, Cox D, Mcdade JE, 1987. Human infection with Ehrlichia canis, a leukocytic Rickettsia. N Engl J Med 316: 853–856.
Dawson JE, Anderson BE, Fishbein DB, Sanchez JL, Goldsmith CS, Wilson KH, Duntley CW, 1991. Isolation and characterization of an Ehrlichia species from a patient diagnosed with human ehrlichiosis. J Clin Microbiol 29: 2741–2745.
Anderson BE, Dawson JE, Jones DC, Wilson KH, 1991. Ehrlichia chaffeensis, a new species associated with human ehrlichiosis. J Clin Microbiol 29: 2838–2842.
Dumler JS, Bakken JS, Eckman MR, Vanetta LL, Chen SM, Walker DH, 1994. Human granulocytic ehrlichiosis: a new, potentially fatal tick-borne infection diagnosed by peripheral blood smear and PCR. Lab Invest 70: A126–A126.
Bakken JS, Dumler JS, Chen SM, Eckman MR, Vanetta LL, Walker DH, 1994. Human granulocytic ehrlichiosis in the upper midwest United States: a new species emerging? JAMA 272: 212–218.
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.
Dumler JS, Barbet AF, Bekker CPJ, 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.
Buller RS, Arens M, Hmiel SP, Paddock CD, Sumner JW, Rikihisa Y, Unver A, Gaudreault-Keener R, Manian FA, Liddell AM, Schmulewitz N, Storch GA, 1999. Ehrlichia ewingii, a newly recognized agent of human ehrlichiosis. N Engl J Med 341: 148–155.
Walker DH, Dumler JS, 2005. Ehrlichia chaffeensis (human monocytic ehrlichiosis), Anaplasma phagocytophilum (human granulocytic anaplasmosis), and other ehrlichieae. Mandell GL, Bennet JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Volume 2. Sixth Edition. New York: Elsevier, 2310–2318.
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.
Eng TR, Harkess JR, Fishbein DB, Dawson JE, Greene CN, Redus MA, Satalowich FT, 1990. Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988. JAMA 264: 2251–2258.
Demma LJ, Holman RC, McQuiston JH, Krebs JW, Swerdlow DL, 2005. Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 2001–2002. Am J Trop Med Hyg 73: 400–409.
McQuiston JH, Paddock CD, Holman RC, Childs JE, 1999. The human ehrlichioses in the United States. Emerg Infect Dis 5: 635–642.
Paddock CD, Yabsley MJ, 2007. Ecological havoc, the rise of White-tailed deer, and the emergence of Amblyomma americanum-associated zoonoses in the United States. Curr Top Microbiol 315: 289–324.
Childs JE, Paddock CD, 2003. The Ascendancy of Amblyomma americanum as a vector of pathogens affecting humans in the United States. Annu Rev Entomol 48: 307–337.
Centers for Disease Control and Prevention, 2006. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis – United States. MMWR Recomm Rep 55: 1–27.
Walker DH, Barbour AG, Oliver JH, Lane RS, Dumler JS, Dennis DT, Persing DH, Azad AF, McSweegan E, 1996. Emerging bacterial zoonotic and vector-borne diseases. Ecological and epidemiological factors. JAMA 275: 463–469.
Mixson TR, Campbell SR, Gill JS, Ginsberg HS, Reichard MV, Schulze TL, Dasch GA, 2006. Prevalence of Ehrlichia, Borrelia, and Rickettsial agents in Amblyomma americanum (Acari: Ixodidae) collected from nine states. J Med Entomol 43: 1261–1268.
Yabsley MJ, Varela AS, Tate CM, Dugan VG, Stallknecht DE, Little SE, Davidson WR, 2002. Ehrlichia ewingii infection in white-tailed deer (Odocoileus virginianus). Emerg Infect Dis 8: 668–671.
Anderson BE, Greene CE, Jones DC, Dawson JE, 1992. Ehrlichia ewingii sp. nov., the etiologic agent of canine granulocytic ehrlichiosis. Int J Syst Bacteriol 42: 299–302.
Steiert JG, Gilfoy F, 2002. Infection rates of Amblyomma americanum and Dermacentor variabilis by Ehrlichia chaffeensis and Ehrlichia ewingii in southwest Missouri. Vector Borne Zoonotic Dis 2: 53–60.
Walls JJ, Greig B, Neitzel DF, Dumler JS, 1997. Natural infection of small mammal species in Minnesota with the agent of human granulocytic ehrlichiosis. J Clin Microbiol 35: 853–855.
Dennis DT, Nekomoto TS, Victor JC, Paul WS, Piesman J, 1998. Reported distribution of Ixodes scapularis and in Ixodes pacificus (Acari: Ixodidae) in the United States. J Med Entomol 35: 629–638.
Counsel of State and Territorial Epidemiologists, 2000. Position Statements 2000 ID-03: Changes in the Case Definition for Human Ehrlichiosis, and Addition of a New Ehrlichiosis Category as a Condition Placed under Surveillance According to the National Public Health Surveillance System (NPHSS). Available at: http://www.cste.org/ps/2000/2000-id-03.htm. Accessed December 8, 2009.
Counsel of State and Territorial Epidemiologists, 2007. Position Statements 2007 ID-03: Revision of the National Surveillance Case Definition for Ehrlichiosis (Ehrlichiosis/Anaplasmosis). Available at: http://www.cste.org/ps/2007ps/2007psfinal/id/07-id-03.pdf. Accessed December 8, 2009.
U.S. Census Bureau, 2008. County Population, Population Change and Estimated Components of Population Change: April 1, 2000 to July 1, 2008. Available at: http://www.census.gov/popest/counties/files/CO-EST2008-ALLDATA.csv. Accessed December 15, 2009.
U.S. Census Bureau, 2008. Annual State Resident Population Estimates for 6 Race Groups (5 Race Alone Groups and One Group with Two or more Race Groups) by Age, Sex, and Hispanic Origin: April 1, 2000 to July 1, 2008. Available at: http://www.census.gov/popest/states/asrh/files/SC-EST2008-alldata6-ALL.csv. Accessed November 20, 2009.
SAS Institute, 2008. SAS System for Windows [computer program]. Version 9.2. Cary, NC: SAS Institute.
Openshaw JJ, Swerdlow DL, Krebs JW, Holman RC, Mandel E, Harvey A, Haberling D, Massung RF, McQuiston JH, 2010. Rocky Mountain spotted fever in the United States, 2000–2007: interpreting contemporary increases in incidence. Am J Trop Med Hyg 83: 174–182.
Bacon RM, Kugeler KJ, Mead PS, 2008. Surveillance for Lyme disease – United States, 1992–2006. MMWR Surveill Summ 57: 1–9.
Antony SJ, Dummer JS, Hunter E, 1995. Human ehrlichiosis in a liver transplant recipient. Transplantation 60: 879–881.
Thomas LD, Hongo I, Bloch KC, Tang YW, Dummer S, 2007. Human ehrlichiosis in transplant recipients. Am J Transplant 7: 1641–1647.
Tan HP, Dumler JS, Maley WR, Klein AS, Burdick JF, Poordad FF, Thuluvath PJ, Markowitz JS, 2001. Human monocytic ehrlichiosis: an emerging pathogen in transplantation. Transplantation 71: 1678–1680.
Adachi JA, Grimm EM, Johnson P, Uthman M, Kaplan B, Rakita RM, 1997. Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature. Transplantation 64: 1139–1142.
Trofe J, Reddy KS, Stratta RJ, Flax SD, Somerville KT, Alloway RR, Egidi MF, Shokouh-Amiri MH, Gaber AO, 2001. Human granulocytic ehrlichiosis in pancreas transplant recipients. Transpl Infect Dis 3: 34–39.
Sadikot R, Shaver MJ, Reeves WB, 1999. Ehrlichia chaffeensis in a renal transplant recipient. Am J Nephrol 19: 674–676.
Eastlund T, Persing D, Mathiesen D, Kim D, Bieging J, McCann P, Heller G, Raynovic S, 1999. Human granulocytic ehrlichiosis after red cell transfusion. Transfusion 39: 117s.
Centers for Disease Control and Prevention, 2008. Anaplasma phagocytophilum transmitted through blood transfusion – Minnesota, 2007. MMWR Morb Mortal Wkly Rep 57: 1145–1148.
Holman RC, Paddock CD, Curns AT, Krebs JW, McQuiston JH, Childs JE, 2001. Analysis of risk factors for fatal Rocky Mountain spotted fever: evidence for superiority of tetracyclines for therapy. J Infect Dis 184: 1437–1444.
Comer JA, Nicholson WL, Olson JG, Childs JE, 1999. Serologic testing for human granulocytic ehrlichiosis at a national referral center. J Clin Microbiol 37: 558–564.
Childs JE, Sumner JW, Nicholson WL, Massung RF, Standaert SM, Paddock CD, 1999. Outcome of diagnostic tests using samples from patients with culture-proven human monocytic ehrlichiosis: implications for surveillance. J Clin Microbiol 37: 2997–3000.
Bakken JS, Goellner P, Van Etten M, Boyle DZ, Swonger OL, Mattson S, Krueth J, Tilden RL, Asanovich K, Walls J, Dumler JS, 1998. Seroprevalence of human granulocytic ehrlichiosis among permanent residents of northwestern Wisconsin. Clin Infect Dis 27: 1491–1496.
Aguero-Rosenfeld ME, Donnarumma L, Zentmaier L, Jacob J, Frey M, Noto R, Carbonaro CA, Wormser GP, 2002. Seroprevalence of antibodies that react with Anaplasma phagocytophila, the agent of human granulocytic ehrlichiosis, in different populations in Westchester County, New York. J Clin Microbiol 40: 2612–2615.
Marshall GS, Jacobs RF, Schutze GE, Paxton H, Buckingham SC, DeVincenzo JP, Jackson MA, San Joaquin VH, Standaert SM, Woods CR, Stu T-BIC, 2002. Ehrlichia chaffeensis seroprevalenee among children in the southeast and south-central regions of the United States. Arch Pediatr Adolesc Med 156: 166–170.
Escarce JJ, Epstein KR, Colby DC, Schwartz JS, 1993. Racial differences in the elderly's use of medical procedures and diagnostic tests. Am J Public Health 83: 948–954.
Lieu TA, Newacheck PW, McManus MA, 1993. Race, ethnicity, and access to ambulatory care among US adolescents. Am J Public Health 83: 960–965.
Hahn RA, 1992. The state of federal health statistics on racial and ethnic groups. JAMA 267: 268–271.
Past two years | Past Year | Past 30 Days | |
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Abstract Views | 3139 | 2842 | 52 |
Full Text Views | 857 | 26 | 1 |
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Ehrlichia chaffeensis causes human monocytic ehrlichiosis, and Anaplasma phagocytophilum causes human granulocytic anaplasmosis. These related tick-borne rickettsial organisms can cause severe and fatal illness. During 2000–2007, the reported incidence rate of E. chaffeensis increased from 0.80 to 3.0 cases/million persons/year. The case-fatality rate was 1.9%, and the hospitalization rate was 49%. During 2000–2007, the reported incidence of A. phagocytophilum increased from 1.4 to 3.0 cases/million persons/year. The case-fatality rate was 0.6%, and the hospitalization rate was 36%. Rates among female patients were lower than among male patients for ehrlichiosis (rate ratio = 0.68) and anaplasmosis (rate ratio = 0.70). Most (80%) ehrlichiosis and anaplasmosis cases met only a probable case definition, although, use of a polymerase chain reaction to confirm infections increased during 2000–2007. Heightened reporting of these diseases will likely continue with improving recognition, changing surveillance practices, and appropriate application of diagnostic assays.
Financial support: This study was supported by the Oak Ridge Institute for Science and Education, the United States Department of Energy, and the Centers for Disease Control and Prevention.
Authors' address: F. Scott Dahlgren, Eric J. Mandel, John W. Krebs, Robert F. Massung, and Jennifer H. McQuiston, Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA.
Maeda K, Markowitz N, Hawley RC, Ristic M, Cox D, Mcdade JE, 1987. Human infection with Ehrlichia canis, a leukocytic Rickettsia. N Engl J Med 316: 853–856.
Dawson JE, Anderson BE, Fishbein DB, Sanchez JL, Goldsmith CS, Wilson KH, Duntley CW, 1991. Isolation and characterization of an Ehrlichia species from a patient diagnosed with human ehrlichiosis. J Clin Microbiol 29: 2741–2745.
Anderson BE, Dawson JE, Jones DC, Wilson KH, 1991. Ehrlichia chaffeensis, a new species associated with human ehrlichiosis. J Clin Microbiol 29: 2838–2842.
Dumler JS, Bakken JS, Eckman MR, Vanetta LL, Chen SM, Walker DH, 1994. Human granulocytic ehrlichiosis: a new, potentially fatal tick-borne infection diagnosed by peripheral blood smear and PCR. Lab Invest 70: A126–A126.
Bakken JS, Dumler JS, Chen SM, Eckman MR, Vanetta LL, Walker DH, 1994. Human granulocytic ehrlichiosis in the upper midwest United States: a new species emerging? JAMA 272: 212–218.
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.
Dumler JS, Barbet AF, Bekker CPJ, 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.
Buller RS, Arens M, Hmiel SP, Paddock CD, Sumner JW, Rikihisa Y, Unver A, Gaudreault-Keener R, Manian FA, Liddell AM, Schmulewitz N, Storch GA, 1999. Ehrlichia ewingii, a newly recognized agent of human ehrlichiosis. N Engl J Med 341: 148–155.
Walker DH, Dumler JS, 2005. Ehrlichia chaffeensis (human monocytic ehrlichiosis), Anaplasma phagocytophilum (human granulocytic anaplasmosis), and other ehrlichieae. Mandell GL, Bennet JE, Dolin R, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Volume 2. Sixth Edition. New York: Elsevier, 2310–2318.
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.
Eng TR, Harkess JR, Fishbein DB, Dawson JE, Greene CN, Redus MA, Satalowich FT, 1990. Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988. JAMA 264: 2251–2258.
Demma LJ, Holman RC, McQuiston JH, Krebs JW, Swerdlow DL, 2005. Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 2001–2002. Am J Trop Med Hyg 73: 400–409.
McQuiston JH, Paddock CD, Holman RC, Childs JE, 1999. The human ehrlichioses in the United States. Emerg Infect Dis 5: 635–642.
Paddock CD, Yabsley MJ, 2007. Ecological havoc, the rise of White-tailed deer, and the emergence of Amblyomma americanum-associated zoonoses in the United States. Curr Top Microbiol 315: 289–324.
Childs JE, Paddock CD, 2003. The Ascendancy of Amblyomma americanum as a vector of pathogens affecting humans in the United States. Annu Rev Entomol 48: 307–337.
Centers for Disease Control and Prevention, 2006. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis – United States. MMWR Recomm Rep 55: 1–27.
Walker DH, Barbour AG, Oliver JH, Lane RS, Dumler JS, Dennis DT, Persing DH, Azad AF, McSweegan E, 1996. Emerging bacterial zoonotic and vector-borne diseases. Ecological and epidemiological factors. JAMA 275: 463–469.
Mixson TR, Campbell SR, Gill JS, Ginsberg HS, Reichard MV, Schulze TL, Dasch GA, 2006. Prevalence of Ehrlichia, Borrelia, and Rickettsial agents in Amblyomma americanum (Acari: Ixodidae) collected from nine states. J Med Entomol 43: 1261–1268.
Yabsley MJ, Varela AS, Tate CM, Dugan VG, Stallknecht DE, Little SE, Davidson WR, 2002. Ehrlichia ewingii infection in white-tailed deer (Odocoileus virginianus). Emerg Infect Dis 8: 668–671.
Anderson BE, Greene CE, Jones DC, Dawson JE, 1992. Ehrlichia ewingii sp. nov., the etiologic agent of canine granulocytic ehrlichiosis. Int J Syst Bacteriol 42: 299–302.
Steiert JG, Gilfoy F, 2002. Infection rates of Amblyomma americanum and Dermacentor variabilis by Ehrlichia chaffeensis and Ehrlichia ewingii in southwest Missouri. Vector Borne Zoonotic Dis 2: 53–60.
Walls JJ, Greig B, Neitzel DF, Dumler JS, 1997. Natural infection of small mammal species in Minnesota with the agent of human granulocytic ehrlichiosis. J Clin Microbiol 35: 853–855.
Dennis DT, Nekomoto TS, Victor JC, Paul WS, Piesman J, 1998. Reported distribution of Ixodes scapularis and in Ixodes pacificus (Acari: Ixodidae) in the United States. J Med Entomol 35: 629–638.
Counsel of State and Territorial Epidemiologists, 2000. Position Statements 2000 ID-03: Changes in the Case Definition for Human Ehrlichiosis, and Addition of a New Ehrlichiosis Category as a Condition Placed under Surveillance According to the National Public Health Surveillance System (NPHSS). Available at: http://www.cste.org/ps/2000/2000-id-03.htm. Accessed December 8, 2009.
Counsel of State and Territorial Epidemiologists, 2007. Position Statements 2007 ID-03: Revision of the National Surveillance Case Definition for Ehrlichiosis (Ehrlichiosis/Anaplasmosis). Available at: http://www.cste.org/ps/2007ps/2007psfinal/id/07-id-03.pdf. Accessed December 8, 2009.
U.S. Census Bureau, 2008. County Population, Population Change and Estimated Components of Population Change: April 1, 2000 to July 1, 2008. Available at: http://www.census.gov/popest/counties/files/CO-EST2008-ALLDATA.csv. Accessed December 15, 2009.
U.S. Census Bureau, 2008. Annual State Resident Population Estimates for 6 Race Groups (5 Race Alone Groups and One Group with Two or more Race Groups) by Age, Sex, and Hispanic Origin: April 1, 2000 to July 1, 2008. Available at: http://www.census.gov/popest/states/asrh/files/SC-EST2008-alldata6-ALL.csv. Accessed November 20, 2009.
SAS Institute, 2008. SAS System for Windows [computer program]. Version 9.2. Cary, NC: SAS Institute.
Openshaw JJ, Swerdlow DL, Krebs JW, Holman RC, Mandel E, Harvey A, Haberling D, Massung RF, McQuiston JH, 2010. Rocky Mountain spotted fever in the United States, 2000–2007: interpreting contemporary increases in incidence. Am J Trop Med Hyg 83: 174–182.
Bacon RM, Kugeler KJ, Mead PS, 2008. Surveillance for Lyme disease – United States, 1992–2006. MMWR Surveill Summ 57: 1–9.
Antony SJ, Dummer JS, Hunter E, 1995. Human ehrlichiosis in a liver transplant recipient. Transplantation 60: 879–881.
Thomas LD, Hongo I, Bloch KC, Tang YW, Dummer S, 2007. Human ehrlichiosis in transplant recipients. Am J Transplant 7: 1641–1647.
Tan HP, Dumler JS, Maley WR, Klein AS, Burdick JF, Poordad FF, Thuluvath PJ, Markowitz JS, 2001. Human monocytic ehrlichiosis: an emerging pathogen in transplantation. Transplantation 71: 1678–1680.
Adachi JA, Grimm EM, Johnson P, Uthman M, Kaplan B, Rakita RM, 1997. Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature. Transplantation 64: 1139–1142.
Trofe J, Reddy KS, Stratta RJ, Flax SD, Somerville KT, Alloway RR, Egidi MF, Shokouh-Amiri MH, Gaber AO, 2001. Human granulocytic ehrlichiosis in pancreas transplant recipients. Transpl Infect Dis 3: 34–39.
Sadikot R, Shaver MJ, Reeves WB, 1999. Ehrlichia chaffeensis in a renal transplant recipient. Am J Nephrol 19: 674–676.
Eastlund T, Persing D, Mathiesen D, Kim D, Bieging J, McCann P, Heller G, Raynovic S, 1999. Human granulocytic ehrlichiosis after red cell transfusion. Transfusion 39: 117s.
Centers for Disease Control and Prevention, 2008. Anaplasma phagocytophilum transmitted through blood transfusion – Minnesota, 2007. MMWR Morb Mortal Wkly Rep 57: 1145–1148.
Holman RC, Paddock CD, Curns AT, Krebs JW, McQuiston JH, Childs JE, 2001. Analysis of risk factors for fatal Rocky Mountain spotted fever: evidence for superiority of tetracyclines for therapy. J Infect Dis 184: 1437–1444.
Comer JA, Nicholson WL, Olson JG, Childs JE, 1999. Serologic testing for human granulocytic ehrlichiosis at a national referral center. J Clin Microbiol 37: 558–564.
Childs JE, Sumner JW, Nicholson WL, Massung RF, Standaert SM, Paddock CD, 1999. Outcome of diagnostic tests using samples from patients with culture-proven human monocytic ehrlichiosis: implications for surveillance. J Clin Microbiol 37: 2997–3000.
Bakken JS, Goellner P, Van Etten M, Boyle DZ, Swonger OL, Mattson S, Krueth J, Tilden RL, Asanovich K, Walls J, Dumler JS, 1998. Seroprevalence of human granulocytic ehrlichiosis among permanent residents of northwestern Wisconsin. Clin Infect Dis 27: 1491–1496.
Aguero-Rosenfeld ME, Donnarumma L, Zentmaier L, Jacob J, Frey M, Noto R, Carbonaro CA, Wormser GP, 2002. Seroprevalence of antibodies that react with Anaplasma phagocytophila, the agent of human granulocytic ehrlichiosis, in different populations in Westchester County, New York. J Clin Microbiol 40: 2612–2615.
Marshall GS, Jacobs RF, Schutze GE, Paxton H, Buckingham SC, DeVincenzo JP, Jackson MA, San Joaquin VH, Standaert SM, Woods CR, Stu T-BIC, 2002. Ehrlichia chaffeensis seroprevalenee among children in the southeast and south-central regions of the United States. Arch Pediatr Adolesc Med 156: 166–170.
Escarce JJ, Epstein KR, Colby DC, Schwartz JS, 1993. Racial differences in the elderly's use of medical procedures and diagnostic tests. Am J Public Health 83: 948–954.
Lieu TA, Newacheck PW, McManus MA, 1993. Race, ethnicity, and access to ambulatory care among US adolescents. Am J Public Health 83: 960–965.
Hahn RA, 1992. The state of federal health statistics on racial and ethnic groups. JAMA 267: 268–271.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3139 | 2842 | 52 |
Full Text Views | 857 | 26 | 1 |
PDF Downloads | 255 | 29 | 0 |