Increasing Incidence of Ehrlichia chaffeensis and Anaplasma phagocytophilum in the United States, 2000–2007

F. Scott Dahlgren Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia

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Eric J. Mandel Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia

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John W. Krebs Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia

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Robert F. Massung Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia

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Jennifer H. McQuiston Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia

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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.

Author Notes

*Address correspondence to Jennifer H. McQuiston, Division of Vectorborne Infectious Diseases, National Center for Enteric, Zoonotic, and Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop G44, Atlanta, GA 30333. E-mail: fzh7@cdc.gov

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.

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