Introduction – Anaplasmosis
Human granulocytic anaplasmosis is caused by an intracellularly (granulocytic) growing gram-negative bacterium formerly known as Ehrlichia, but now renamed to Anaplasma phagocytophilum.
Various types of anaplasmoses are well-known causes of fever in horses, dogs, cats and cattle, with many veterinary cases in the world. They do not transmit person to person.
The disease is spread through tick bites and occurs in areas that are endemic to other tick-borne infections. Double infection with borrelia is reported. Only a few cases are detected. Many infections are mild and self-resolving. The infection is difficult to diagnose and is often overlooked.
It is is not required to report cases of anaplasmosis to local public health authorities.
Symptoms and Clinical Findings – Anaplasmosis
- Fever, chills, night sweats (about 10-14 days without treatment)
- Headache
- Myalgia
- Tiredness
- Malaise
- Nausea, vomiting, abdominal pain, diarrhea, cough, neurological symptoms, redness may also occur.
Complications – Anaplasmosis
- Prolonged fatigue can occur.
- Even without treatment, most people recover without complications.
Diagnostics
- Clinically difficult diagnosis
- Serology becomes positive only after 1-2 weeks of illness. Take a convalescent serum test 4 weeks after the disease onset.
- In blood smears, intracellular inclusions (morulas) can sometimes be seen.
- Leukopenia (moderate)
- Thrombocytopenia (moderate)
- Liver transaminase + LD increase
- Mild anemia
- SR elevated
- CRP (usually 30-150 mg/L)
Incubation Period
- 7-10 days
Differential Diagnoses – Anaplasmosis
- Viruses, such as CMV, mononucleosis
- Tularemia
- Malignancies
Prophylaxis
- Protective clothing in the forest.
- Inspection of the body and removal of ticks after an excursion to the woods.
Treatment – Anaplasmosis
- Doxycycline (Doxyferm, Doxycycline EQL Pharma) 100 mg 2 x 1 per os for 10-14 days.
Treatment should be effective after a few days if the diagnosis is correct.
Further Reading
- Systematic review and meta-analysis of tick-borne disease risk factors in residential yards, neighborhoods, and beyond.
- Prevalence of Anaplasma species in India and the World in dairy animals: A systematic review and meta-analysis.
- Meta-analysis of coinfection and coexposure with Borrelia burgdorferi and Anaplasma phagocytophilum in humans, domestic animals, wildlife, and Ixodes ricinus-complex ticks.
- A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe.
- Human Tick-Borne Diseases in Australia.
