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Volume 6, Number 3—June 2000
Letter

Serologic Evidence of Human Monocytic and Granulocytic Ehrlichiosis in Israel

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Letter to the Editor: Our article on ehrlichiosis in Israel is one of several reporting serologic evidence of ehrlichiosis outside North America (1-4). Serologic tests were performed for immunoglobulin (IgG) antibodies to Ehrlichia chaffeensis, E. canis, and human granulocytic ehrlichiosis (HGE) agent to prevent misinterpretation due to cross-reaction. The conclusions meet the criteria published by the American Society for Rickettsiology, in which a confirmed diagnosis of human monocytic ehrlichiosis (HME) is based on a "single serum titer of 256" in a patient with clinically compatible disease (5).

The argument that the same epidemiologic circumstances that exist in the United States have to be prevalent in Israel for the disease to be present is not compelling. Reporting serologic evidence of ehrlichiosis in Israel alerts physicians to the possibility of HME and HGE when they see patients with symptoms compatible with these diseases. We agree that isolation and molecular identification of both agents are essential to confirming the presence of these diseases in Israel.

Read original article: http://www.cdc.gov/ncidod/eid/vol5no6/keysary.htmLetter to the Editor regarding Keysary's original article: http://www.cdc.gov/ncidod/eid/vol6no3/brouqui.htm

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Avi Keysary and Trevor Waner

Author affiliations: Israel Institute for Biological Research, Ness Ziona, Israel

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References

  1. Keysary  A, Amram  L, Keren  G, Sthoeger  A, Potasman  I, Jacob  A, Serologic evidence of human monocytic and granulocytic ehrlichiosis in Israel. Emerg Infect Dis. 1999;5:7758. DOIPubMed
  2. Morais  JD, Dawson  JE, Greene  C, Filipe  AR, Galhardas  LC, Bacellar  F. First European case of ehrlichiosis. Lancet. 1991;338:6334.PubMed
  3. Bakken  JS, Krueth  J, Tilden  RL, Dumler  JS, Kristiansen  BE. Serological evidence of human granulocytic ehrlichiosis in Norway. Eur J Microbiol Infect Dis. 1996;15:82932. DOI
  4. Christova  IS, Dumler  JS. Human granulocytic ehrlichiosis in Bulgaria. Am J Trop Med Hyg. 1999;60:5861.PubMed
  5. Walker  DH. Consensus workshop on diagnosis of human ehrlichiosis. Bulletin of the American Society for Rickettsiology. 1999;2:18.

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Cite This Article

DOI: 10.3201/eid0603.000317

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Table of Contents – Volume 6, Number 3—June 2000

Page created: December 16, 2010
Page updated: December 16, 2010
Page reviewed: December 16, 2010
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.
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