Ehrlichiosis and Anaplasmosis Fact Sheet
The Diseases and Transmission
- Ehrlichia and Anaplasma are related bacteria that are transmitted by ticks. These bacteria infect white blood cells in humans. 
- There are three different bacteria that cause disease in humans: 
 
| Pathogen | Ehrlichia Chaffeensis | Ehrlichia ewingii | Anaplasma Phagocytophilum (formerly ehrlichichia phagocytophilia) | 
| Disease | Human moncytic ehrlichiosis (HME) | Ehrlichiosis ewingii | Human granulocytic anaplasmosis (HGA, formerly HGE) | 
| Tick Vector | Amblyomma Americanum (lone start tick) | Ixodes scapularis (black legged tick) | 
| Location | Southeast and south central US | Northeast and upper Midwest US | 
 
- Animal reservoirs for E. chaffeensis and E. ewingii are white-tailed deer and dogs. The reservoirs for A. phagocytophilum include cattle, deer and rodents. You cannot get the diseases directly from animals. 
- The diseases are not spread between humans other than through blood transfusions. 
- Maryland is home to both the lone star tick and the black-legged tick. 
 
 
Symptoms and Treatment
| Disease | Clinical Features | 
| HME, Ehrlichiosis ewingii | ·         Symptoms appear 1 to 2 weeks after a tick bite. ·         Symptoms include fever, headache, muscle aches, nausea, vomiting, diarrhea, confusion, chills and malaise. ·         Conjunctival infection (red eyes) ·         Development of a rash may occur in up to 60% of children and Mountain spotted fever.   | 
| HGA | ·         Symptoms appear 1 to 2 weeks after a tick bite.  ·         Symptoms include fever, headache, cough, nausea/abdominal pain, chills, malaise, confusion and muscle aches.  ·         Rash is rare   | 
 
 
- Most infections occur when tick activity is highest, in late spring and summer. 
- If left untreated, HME and HGA may be severe. 
- Co-infection with more than one tickborne disease is possible. 
- Persons with compromised immunity caused by immunosuppressive therapies (e.g., corticosteroids, cancer chemotherapy, or longterm immunosuppressive therapy following organ transplant), HIV infection, or splenectomy appear to develop more severe disease. 
- Contact your health care provider if you develop any of these symptoms after a tick bite or after being in tick habitat. Your health care provider may order a blood test to help diagnose the disease. 
- The diseases are effectively treated with antibiotics, most commonly doxycycline.
 
 
Prevention Tips
- Ticks are most active from late spring through early fall 
- Insect repellent containing 20-30% DEET is receommended to prevent tick or fly bites. 
- Repellents with up to 30% DEET can safely be used on children over 2 months of age. 
- Treat clothes with permethrin (don't use permethrin directly on skin). 
- Long pants and long sleeves help keep ticks off of skin, and tucking pant legs into socks and shirts into pants keeps ticks on outside of clothing. 
- Light colored clothing lets you spot ticks more easily. 
- Talk to your veterinarian about tick control products for your pets. 
- When enjoying the outdoors, avoid wooded or brushy areas with tall grass and leaf litter and walk in the center of trails. 
- Check yourself, your kids and your pets daily for ticks when spending time in tick habitat. 
- Bathe or shower as soon as possible after coming indoors (within 2 hours) to wash off ticks. 
- Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothes after you come indoors.
 
 
To Remove Ticks 
- Use fine-tipped tweezers. 
- Grab the tick close to the skin; do not twist or jerk the tick. 
- Gently pull straight up until all parts of the tick are removed. 
- Wash your hands with soap and water or an alcohol-based rub. 
- Clean the site of the tick bite with soap and water or an antiseptic. 
- Do not use petroleum jelly, a hot match, nail polish, or other products to remove ticks.
 
 
For more information on tick borne diseases, visit: