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Ehrlichiosis

Ehrlichiosis is also refered to as canine rickettsiosis, canine hemorrhagic fever, canine typhus, tracker dog disease, and tropical canine pancytopenia. It is a tick-borne disease of dogs that is caused by the organism Ehrlichia. Dogs, cats, and in rare instances, humans are affected. German Shepherd dogs are known to be particularly affected by the disease. more...

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Erlichia

There are several species of Ehrlichia, but the one that most commonly affects dogs and causes the most severe clinical signs is Ehrlichia canis. The brown dog tick, or Rhipicephalus sanguineous, that passes the Ehrlichia to the dog is prevalent throughout most of the United States, but most cases tend to occur in the Southwest and Gulf Coast regions where there is a high concentration of the tick.

Disease Overview

Dogs get ehrlichiosis from the brown dog tick, which passes an ehrlichia organism into the bloodstream when it bites. There are three stages of ehrlichiosis, each varying in severity. The acute stage, occurring several weeks after infection and lasting for up to a month, can lead to fever and lowered peripheral blood cell counts. The second stage, called the subclinical phase, has no outward signs and can last for the remainder of the dog's life, during which the dog remains infected with the organism. In some dog breeds, such as the German Shepherd dog, the third and most serious stage of infection, the chronic phase, will commence. Very low blood cell counts (pancytopenia), bleeding, bacterial infection, lameness, neurological and ophthalmic disorders, and kidney disease, can result. Chronic ehrlichiosis can be fatal.

Treatments

Antibiotics, administered for an extended period of time, are effective at eliminating the infection. Dogs with severe cases of chronic ehrlichiosis cannot be cured, but supportive care and treatment of diseases secondary to the infection, such as anemia, can help stabilize the dog.

Signs and symptoms

The acute stage of the disease, occurring most often in the spring and summer, begins one to three weeks after infection and lasts for two to four weeks. Clinical signs include a fever, petechiae, bleeding disorders, and vasculitis. There are no outward signs of the subclinical phase. Clinical signs of the chronic phase include pale gums due to anemia, bleeding due to thrombocytopenia, vasculitis, lymphadenopathy, respiratory dyspnea, coughing, polyuria, polydipsia, lameness, ophthalmic diseases such as retinal hemorrhage and anterior uveitis, and neurological disease. Dogs that are severely affected can die from this disease.

Although people can get ehrlichiosis, dogs do not transmit the bacteria to humans; rather, ticks pass on the ehrlichia organism. Clinical signs of human ehrlichiosis include fever, headache, eye pain, and gastrointestinal upset.

Diagnosis

Diagnosis is achieved most commonly by serologic testing of the blood for the presence of antibodies against the ehrlichia organism. Many veterinarians routinely test for the disease, especially in enzootic areas. It should be noted, however, that during the acute phase of infection, the test can be falsely negative because the body will not have had time to make antibodies to the infection. As such, the test should be repeated. In addition, blood tests may show abnormalities in the numbers of red cells, white cells, and platelets, if the disease is present. Uncommonly, a diagnosis can be made by looking under a microscope at a blood smear for the presence of the ehrlichia organism, which sometimes can be seen within a white blood cell.

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Ehrlichiosis
From Gale Encyclopedia of Medicine, 4/6/01 by Belinda M. Rowland

Definition

Ehrlichiosis is a bacterial infection that is spread by ticks. Symptoms include fever, chills, headache, muscle aches, and tiredness.

Description

Ehrlichiosis is a tick-borne disease caused by infection with Ehrlichia bacteria. Ticks are small, blood-sucking arachnids. Although some ticks carry disease-causing organisms, most do not. When an animal or person is bitten by a tick which carries bacteria, the bacteria are passed to that person or animal during the tick's feeding process. It is believed that the tick must remain attached to the person or animal for at least 24 hours to spread the infection.

There are two forms of ehrlichiosis in the United States; human monocytic ehrlichiosis and human granulocytic ehrlichiosis. Monocytic ehrlichiosis is caused by Ehrlichia chaffeensis, which is spread by the Lone Star tick, Amblyomma americanum. As of early 1998, about 400 cases of monocytic ehrlichiosis had been reported in 30 states, primarily in the southeastern and south central United States. The bacteria which causes granulocytic ehrlichiosis is not known but suspected to be either Ehrlichia equi or Ehrlichia phagocytophila. Granulocytic ehrlichiosis is probably spread by the blacklegged tick Ixodes scapularis (which also spreads Lyme disease). About 100 cases of granulocytic ehrlichiosis have been reported in Connecticut, Massachusetts, Rhode Island, Minnesota, New York, and Wisconsin.

Causes & symptoms

Both forms of ehrlichiosis have similar symptoms and the illnesses can range from mild to severe and life-threatening. Risk factors include old age and exposure to ticks through work or recreation. Symptoms occur between 7-21 days following a tick bite although patients may not recall having a tick bite. Fever, tiredness, headache, muscle aches, chills, loss of appetite, confusion, nausea, and vomiting are common to both diseases. A rash may occur.

Diagnosis

Ehrlichiosis may be diagnosed and treated by doctors who specialize in blood diseases (hematologists) or an infectious disease specialist. Because ehrlichiosis is not very common and the symptoms are not unique, it may be misdiagnosed. A recent history of a tick bite is helpful in the diagnosis. Blood tests will be done to look for antibodies to Ehrlichia. Staining and microscopic examination of the blood sample may show Ehrlichia bacteria inside white blood cells. Another test, called polymerase chain reaction (PCR), is a very sensitive assay to detect bacteria in the blood sample, but it is not always available.

Treatment

Antibiotic treatment should begin immediately if ehrlichiosis is suspected, even if laboratory results are not available. Treatment with either tetracycline (Sumycin, Achromycin V) or doxycycline (Monodox, Vibramycin) is recommended. Many patients with ehrlichiosis are admitted to the hospital for treatment.

Prognosis

For otherwise healthy people, a full recovery is expected following treatment for ehrlichiosis. Elderly patients are at a higher risk for severe disease, which may be fatal. Serious complications include lung or gastrointestinal bleeding. Two to ten patients out of 100 die from the disease.

Prevention

The only prevention for ehrlichiosis is to minimize exposure to ticks by staying on the trail when walking through the woods, avoiding tall grasses, wearing long sleeves and tucking pant legs into socks, wearing insect repellent, and checking for ticks after an outing. Remove a tick as soon as possible by grasping the tick with tweezers and gently pulling.

Key Terms

Tick-borne disease
A disease which is spread to animals by the bite of an infected tick.

Further Reading

For Your Information

    Books

  • McDade, Joseph E., and James G. Olsen. "Ehrlichiosis, Q Fever, Typhus, Rickettsialpox, and Other Rickettsioses." In Infectious Diseases, 2nd ed. Philadelphia: W.B. Saunders Company, 1998.

    Other

  • Mayo Health Oasis. 1998. http://www.mayohealth.org (5 March 1998).

Gale Encyclopedia of Medicine. Gale Research, 1999.

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