Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 31, Number 2—February 2025
Research

Contribution of Limited Molecular Testing to Low Ehrlichiosis Diagnosis in High Incidence Area, North Carolina, USA

Alexis Siegler, Lauryn Ursery, Dana A. Giandomenico, Melissa B. Miller, Johanna S. Salzer, Alexis M. Barbarin, Carl Williams, and Ross M. BoyceComments to Author 
Author affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA (A. Siegler, L. Ursery, D.A. Giandomenico, M.B. Miller, R.M. Boyce); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.S. Salzer); North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA (A.M. Barbarin, C. Williams)

Main Article

Figure

Flowchart describing use of testing to diagnosis ehrlichiosis within the University of North Carolina health system, March 24, 2022–April 14, 2023. CSTE criteria are described in (18). CSTE, Council of State and Territorial Epidemiologists; TBD, tickborne disease.

Figure. Flowchart describing use of testing to diagnosis ehrlichiosis within the University of North Carolina health system, March 24, 2022–April 14, 2023. CSTE criteria are described in (18). CSTE, Council of State and Territorial Epidemiologists; TBD, tickborne disease.

Main Article

References
  1. Centers for Disease Control and Prevention. Ehrlichiosis epidemiology and statistics [cited 2023 May 13]. https://www.cdc.gov/ehrlichiosis/stats
  2. Boyce  RM, Sanfilippo  AM, Boulos  JM, Cleinmark  M, Schmitz  J, Meshnick  S. Ehrlichia Infections, North Carolina, USA, 2016. Emerg Infect Dis. 2018;24:208790. DOIPubMedGoogle Scholar
  3. Nichols Heitman  K, Dahlgren  FS, Drexler  NA, Massung  RF, Behravesh  CB. Increasing incidence of ehrlichiosis in the United States: a summary of national surveillance of Ehrlichia chaffeensis and Ehrlichia ewingii infections in the United States, 2008–2012. Am J Trop Med Hyg. 2016;94:5260. DOIPubMedGoogle Scholar
  4. Kuriakose  K, Pettit  AC, Schmitz  J, Moncayo  A, Bloch  KC. Assessment of risk factors and outcomes of severe ehrlichiosis infection. JAMA Netw Open. 2020;3:e2025577. DOIPubMedGoogle Scholar
  5. Hamburg  BJ, Storch  GA, Micek  ST, Kollef  MH. The importance of early treatment with doxycycline in human ehrlichiosis. Medicine (Baltimore). 2008;87:5360. DOIPubMedGoogle Scholar
  6. Biggs  HM, Behravesh  CB, Bradley  KK, Dahlgren  FS, Drexler  NA, Dumler  JS, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis—United States. MMWR Recomm Rep. 2016;65:144. DOIPubMedGoogle Scholar
  7. Bakken  JS, Haller  I, Riddell  D, Walls  JJ, Dumler  JS. The serological response of patients infected with the agent of human granulocytic ehrlichiosis. Clin Infect Dis. 2002;34:227. DOIPubMedGoogle Scholar
  8. Dumler  JS, Madigan  JE, Pusterla  N, Bakken  JS. Ehrlichioses in humans: epidemiology, clinical presentation, diagnosis, and treatment. Clin Infect Dis. 2007;45(Suppl 1):S4551. DOIPubMedGoogle Scholar
  9. Zychowski  DL, Alvarez  C, Abernathy  H, Giandomenico  D, Choudhary  SK, Vorobiov  JM, et al. Tick-borne disease infections and chronic musculoskeletal pain. JAMA Netw Open. 2024;7:e2351418. DOIPubMedGoogle Scholar
  10. Mokashi  NV, Brown Marusiak  A, Giandomenico  D, Cleinmark  M, Schmitz  JL, Boyce  RM. Does paging clinicians about tick-borne disease serological results impact clinical care? A retrospective analysis of 70 cases in North Carolina. Am J Trop Med Hyg. 2024;110:8158. DOIPubMedGoogle Scholar
  11. Council of State and Territorial Epidemiologists. Update to public health reporting and national notification for ehrlichiosis. Vol. 23-ID-04. 2023 [cited 2024 Feb 2]. https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/ps_2023/23-ID-04_Ehrlichiosis.pdf
  12. North Carolina Division of Public Health. Ehrlichiosis surveillance from 2016–2021 [cited 2023 Jan 10]. https://epi.dph.ncdhhs.gov/cd/ehrlichiosis/EhrlichiosisSurveillanceSummary2021.pdf
  13. Brown Marusiak  A, Hollingsworth  BD, Abernathy  H, Alejo  A, Arahirwa  V, Mansour  O, et al. Patterns testing for tick-borne diseases and implications for surveillance in the southeastern US. JAMA Netw Open. 2022;5:e2212334. DOIPubMedGoogle Scholar
  14. Eshoo  MW, Crowder  CD, Li  H, Matthews  HE, Meng  S, Sefers  SE, et al. Detection and identification of Ehrlichia species in blood by use of PCR and electrospray ionization mass spectrometry. J Clin Microbiol. 2010;48:4728. DOIPubMedGoogle Scholar
  15. The University of North Carolina Health System. 2021 Annual report [cited 2023 Dec 20]. https://www.unchealthcare.org/app/files/public/9676dff4-3a41-42ce-b177-1a25647a0c62/pdf-UNC_Health_2021_Annual_Report.pdf
  16. Mayo Foundation for Medical Education and Research. TEST ID: EPCRB—Ehrlichia/Anaplasma, molecular detection, PCR, blood [cited 2023 Dec 21]. https://www.mayocliniclabs.com/test-catalog/Overview/618301#Performance
  17. Harris  PA, Taylor  R, Thielke  R, Payne  J, Gonzalez  N, Conde  JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:37781. DOIPubMedGoogle Scholar
  18. Council of State and Territorial Epidemiologists. Revision of the national surveillance case definition for ehrlichiosis (Ehrlichiosis/Anaplasmosis). Vol. 07-ID-03. 2007 [cited 2024 Feb 21]. https://cdn.ymaws.com/www.cste.org/resource/resmgr/PS/07-ID-03.pdf
  19. Lee  S, Kakumanu  ML, Ponnusamy  L, Vaughn  M, Funkhouser  S, Thornton  H, et al. Prevalence of Rickettsiales in ticks removed from the skin of outdoor workers in North Carolina. Parasit Vectors. 2014;7:607. DOIPubMedGoogle Scholar
  20. Wolf  L, McPherson  T, Harrison  B, Engber  B, Anderson  A, Whitt  P. Prevalence of Ehrlichia ewingii in Amblyomma americanum in North Carolina. J Clin Microbiol. 2000;38:2795. DOIPubMedGoogle Scholar

Main Article

Page created: January 13, 2025
Page updated: January 16, 2025
Page reviewed: January 16, 2025
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external