Human Infection with Ehrlichia muris –like Pathogen, United States, 2007–20131

• Published in: Emerging infectious diseases 2015-10, Vol.21 (10), p.1794-1799
• Main Authors: Johnson, Diep K. Hoang, Schiffman, Elizabeth K., Davis, Jeffrey P., Neitzel, David F., Sloan, Lynne M., Nicholson, William L., Fritsche, Thomas R., Steward, Christopher R., Ray, Julie A., Miller, Tracy K., Feist, Michelle A., Uphoff, Timothy S., Franson, Joni J., Livermore, Amy L., Deedon, Alecia K., Theel, Elitza S., Pritt, Bobbi S.
• Format: Article
• Language: English
• Subjects: Human Infection with; like Pathogen, United States, 2007–2013
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2110.150143

This pathogen has been detected in patients from 5 states, all of whom reported likely tick exposure in Minnesota or Wisconsin. An Ehrlichia muris– like (EML) pathogen was detected among 4 patients in Minnesota and Wisconsin during 2009. We characterized additional cases clinically and epidemiologically. During 2004–2013, blood samples from 75,077 patients from all 50 United States were tested by PCR from the groEL gene for Ehrlichia spp. and Anaplasma phagocytophilum . During 2007–2013, samples from 69 (0.1%) patients were positive for the EML pathogen; patients were from 5 states: Indiana (1), Michigan (1), Minnesota (33), North Dakota (3), and Wisconsin (31). Most (64%) patients were male; median age was 63 (range 15–94) years; and all 69 patients reported likely tick exposure in Minnesota or Wisconsin. Fever, malaise, thrombocytopenia, and lymphopenia were the most common symptoms. Sixteen (23%) patients were hospitalized (median 4 days); all recovered, and 96% received doxycycline. Infection with the EML pathogen should be considered for persons reporting tick exposure in Minnesota or Wisconsin.