WordNet

sing with closed lips; "She hummed a melody"
a humming noise; "the hum of distant traffic" (同)humming
be noisy with activity; "This office is buzzing with activity" (同)buzz, seethe
sound with a monotonous hum (同)thrum
make a low continuous sound; "The refrigerator is humming"
relating to a person; "the experiment was conducted on 6 monkeys and 2 human subjects"
characteristic of humanity; "human nature"
having human form or attributes as opposed to those of animals or divine beings; "human beings"; "the human body"; "human kindness"; "human frailty"
of or relating to granulocytes

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〈ハチ・機械などが〉『ブンブンいう』,ブーンと鳴る / 『鼻歌を歌う』,ハミングスル / (ちゅうちょ・当惑で)ふむふむいう / 《話》〈雰囲気・事業などが〉活気がある,活発に動く;(…で)活気づく《+『with』+『名』》 / …‘を'『ハミングで歌う』,鼻歌を歌って…‘を'(ある状熊に)する / (ハチ・機械などの)『ブンブン』[『うなる音』];鼻歌 / (雑踏などの)ガヤガヤ]いう音],騒音 / ふ‐む,う‐ん(ちゅうちょ・当惑・黙考・疑惑・不快などの声)
(動物・神に対して)『人間の』,人の / 『人間らいし』,人間的な,人情味のある / 〈C〉《複数形》(動物に怠して)人間(human being) / 〈U〉《the human》人類

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/09 14:21:54」(JST)

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Human granulocytic anaplasmosis (HGA) (previously known as Human granulocytic ehrlichiosis, or HGE^[1]^[2] ) is an infectious disease caused by Anaplasma phagocytophilum, an obligate intracellular bacterium that is typically transmitted to humans by at least three kinds of ticks, including Ixodes scapularis, Ixodes pacificus, and Dermacentor variabilis. These ticks also transmit Lyme disease and other diseases.^[3]

The bacteria infect white blood cells called neutrophils, causing changes in gene expression that prolong the life of these otherwise short-lived cells.^[4]

Ecology and epidemiology

A. phagocytophilum is transmitted to humans by Ixodes ticks. These ticks are found in the US, Europe, and Asia. In the US, I. scapularis is the tick vector in the East and Midwest states, and I. pacificus in the Pacific Northwest.^[5]

The major mammalian reservoir for A. phagocytophilum in the eastern United States is the white-footed mouse, Peromyscus leucopus. Although white-tailed deer harbor A. phagocytophilum, evidence suggests that they are not a reservoir for the strains that cause HGA.^[6]

Anaplasma phagocytophilum shares its tick vector with other human pathogens, and about 10% of patients with HGA show serologic evidence of coinfection with Lyme disease, babesiosis, or tick-borne meningoencephalitis.^[7]

Symptoms

Symptoms may include fever, severe headache, muscle aches (myalgia), chills and shaking, similar to the symptoms of influenza. Symptoms may be minor, as evidenced by surveillance studies in high-risk areas. GI symptoms occur in less than half of patients and a skin rash is seen in less than 10% of patients. It is also characterized by thrombocytopenia, leukopenia, and elevated serum transaminase levels in the majority of infected patients.^[8]

Diagnosis

Clinically, HGA is essentially indistinguishable from Human monocytic ehrlichiosis, the infection caused by Ehrlichia chaffeensis, and other tick-borne illnesses such as Lyme disease may be suspected. As Ehrlichia serologies can be negative in the acute period, PCR is very useful for diagnosis.^[9]

Treatment and Prevention

Doxycycline is the treatment of choice. If anaplasmosis is suspected, treatment should not be delayed while waiting for a definitive laboratory confirmation, as prompt doxycycline therapy has been shown to improve outcomes.^[10] Presentation during early pregnancy can complicate treatment. Doxycycline compromises dental enamel during development.^[11] Although rifampin is indicated for post-delivery pediatric and some doxycycline-allergic patients, it is teratogenic. Rifampin is contraindicated during conception and pregnancy.^[12] Currently, there is no vaccine against human granulocytic anaplasmosis.

Terminology

Although the infectious agent is known to be from the Anaplasma genus, the term "human granulocytic ehrlichiosis" (HGE) is often used, reflecting the prior classification of the organism. E. phagocytophilum and E. equi were reclassified as Anaplasma phagocytophilum.

External links

CDC Emerging Infectious Diseases for more information about HGE

References

^ Malik A, Jameel M, Ali S, Mir S (2005). "Human granulocytic anaplasmosis affecting the myocardium". J Gen Intern Med 20 (10): 958. doi:10.1111/j.1525-1497.2005.00218.x. PMC 1490240. PMID 16191146.
^ Human Anaplasmosis Basics - Minnesota Dept. of Health
^ http://www.bioone.org/doi/abs/10.1603/0022-2585%282003%29040%5B0534%3ADOBBEC%5D2.0.CO%3B2
^ PMID: Lee HC, Kioi M, Han J, Puri RK, Goodman JL (September 2008). "Anaplasma phagocytophilum-induced gene expression in both human neutrophils and HL-60 cells". Genomics 92 (3): 144–51. doi:10.1016/j.ygeno.2008.05.005. PMID 18603403.
^ Dumler JS, Madigan JE, Pusterla N, Bakken JS (July 2007). "Ehrlichioses in humans: epidemiology, clinical presentation, diagnosis, and treatment". Clinical Infectious Diseases 45 (Suppl 1): S45–51. doi:10.1086/518146. PMID 17582569.
^ Massung RF, Courtney JW, Hiratzka SL, Pitzer VE, Smith G, Dryden RL (October 2005). "Anaplasma phagocytophilum in white-tailed deer". Emerging Infectious Diseases 11 (10): 1604–6. doi:10.3201/eid1110.041329. PMID 16318705.
^ Dumler JS, Choi KS, Garcia-Garcia JC, et al. (December 2005). "Human granulocytic anaplasmosis and Anaplasma phagocytophilum". Emerging Infectious Diseases 11 (12): 1828–34. doi:10.3201/eid1112.050898. PMID 16485466.
^ Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. Medical Microbiology, Fifth Edition. United States: Elsevier Mosby, 2005
^ Prince LK, Shah AA, Martinez LJ, Moran KA (August 2007). "Ehrlichiosis: making the diagnosis in the acute setting". Southern Medical Journal 100 (8): 825–8. doi:10.1097/smj.0b013e31804aa1ad. PMID 17713310.
^ Hamburg BJ, Storch GA, Micek ST, Kollef MH (March 2008). "The importance of early treatment with doxycycline in human ehrlichiosis". Medicine 87 (2): 53–60. doi:10.1097/MD.0b013e318168da1d. PMID 18344803.
^ Muffly T, McCormick TC, Cook C, Wall J (2008). "Human granulocytic ehrlichiosis complicating early pregnancy". Infect Dis Obstet Gynecol 2008: 359172. doi:10.1155/2008/359172. PMC 2396214. PMID 18509484.
^ Krause PJ, Corrow CL, Bakken JS (September 2003). "Successful treatment of human granulocytic ehrlichiosis in children using rifampin". Pediatrics 112 (3 Pt 1): e252–3. doi:10.1542/peds.112.3.e252. PMID 12949322.

UpToDate Contents

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1. ヒトエーリキア症およびアナプラズマ症 human ehrlichiosis and anaplasmosis
2. エーリキアの生物学 biology of ehrlichiae
3. 犬からの人畜共通感染症 zoonoses from dogs
4. 猫からの人畜共通感染症 zoonoses from cats
5. 小児および思春期における急性ウイルス性脳炎：治療および予防 acute viral encephalitis in children and adolescents treatment and prevention

English Journal

Temporal and spatial variation in Anaplasma phagocytophilum infection in Swedish moose (Alces alces).

Malmsten J, Widén DG, Rydevik G, Yon L, Hutchings MR, Thulin CG, Söderquist L, Aspan A, Stuen S, Dalin AM.Author information Department of Pathology and Wildlife Diseases, National Veterinary Institute, Uppsala, Sweden.AbstractSUMMARY The occurrence of Anaplasma phagocytophilum was investigated in spleen and serum samples from Swedish moose (Alces alces) in southern Sweden (island and mainland). Samples were analysed for presence of A. phagocytophilum DNA by real-time PCR (n = 263), and for Anaplasma antibodies with ELISA serology (n = 234). All serum samples had antibodies against A. phagocytophilum. The mean DNA-based prevalence was 26·3%, and significant (P < 0·01) temporal, and spatial variation was found. Island moose had significantly (P < 0·001) higher prevalence of A. phagocytophilum DNA than moose from the mainland areas. Two samples were sequenced to determine genetic variation in the 16S rRNA and groESL genes. Genetic sequence similarity with the human granulocytic anaplasmosis agent, equine granulocytic ehrlichiosis agent, and different wildlife-associated A. phagocytophilum variants were observed in the 16S rRNA and groESL genes. Our study shows that moose are exposed to A. phagocytophilum in Sweden, and represent a potential wildlife reservoir of the pathogen.
Epidemiology and infection.Epidemiol Infect.2013 Sep 4:1-9. [Epub ahead of print]
SUMMARY The occurrence of Anaplasma phagocytophilum was investigated in spleen and serum samples from Swedish moose (Alces alces) in southern Sweden (island and mainland). Samples were analysed for presence of A. phagocytophilum DNA by real-time PCR (n = 263), and for Anaplasma antibodies with ELI
PMID 24001524

Detection of A. phagocytophilum and E. chaffeensis in patient and mouse blood and ticks by a duplex real-time PCR assay.

Dong T, Qu Z, Zhang L.Author information School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China ; Department of Anaplasma, National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.AbstractHuman granulocytic anaplasmosis (HGA) and human monocytic ehrlichiosis (HME) are emerging, tick-borne, zoonotic infectious diseases caused by Anaplasma phagocytophilum and Ehrlichia chaffeensis, respectively. Early diagnosis is essential for rapid clinical treatment to avoid misdiagnosis and severe patient outcomes. Simple, sensitive and reliable diagnostic methods are urgently needed. In this study, we developed a duplex real-time PCR assay targeting the A. phagocytophilum ankA gene and the E. chaffeensis TRP120 gene, respectively. The lowest limit of detection of the duplex real-time PCR assay was 100 copies of the targeted A. phagocytophilum ankA gene and the E. chaffeensis TRP120 gene per reaction, and the specificity was 100%. Detection in blood DNA samples from the acute stage of illness for 22 HGA cases and 8 HME cases indicated that the duplex real-time PCR assay was more sensitive than the nested PCR assay. The infection of Citellusundulatus Pallas with A. phagocytophilum and E. chaffeensis was first confirmed in Xinjiang Province and the positive rate was 3.1% for A. phagocytophilum, 6.3% for E. chaffeensis and 3.1% for co-infection with both pathogens. The rates of A. phagocytophilum and E. chaffeensis infection of D. silvarum ticks collected from Shanxi Province were 8.2% and 14.8%, respectively, and the co-infection rate was 3.3%. The rates of A. phagocytophilum and E. chaffeensis infection in H. longicornis ticks collected from Shandong Province were 1.6% and 6.3%, respectively, and the co-infection rate was 1.6%.
PloS one.PLoS One.2013 Sep 4;8(9):e74796. doi: 10.1371/journal.pone.0074796.
Human granulocytic anaplasmosis (HGA) and human monocytic ehrlichiosis (HME) are emerging, tick-borne, zoonotic infectious diseases caused by Anaplasma phagocytophilum and Ehrlichia chaffeensis, respectively. Early diagnosis is essential for rapid clinical treatment to avoid misdiagnosis and severe
PMID 24023963

Spatial and seasonal variation in the prevalence of Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato in questing Ixodes ricinus ticks in Norway.

Mysterud A, Easterday WR, Qviller L, Viljugrein H, Ytrehus B.AbstractBACKGROUND: Understanding the variation in prevalence of Borrelia burgdorferi sensu lato (Lyme Borreliosis Spirochaetes, LBS) and A. phagocytophilum (causing tick-borne fever in ruminants and human granulocytic ehrlichiosis) in ticks is vital from both a human and an animal disease perspective to target the most effective mitigation measures. From the host competence hypothesis, we predicted that prevalence of LBS would decrease with red deer density, while prevalence of A. phagocytophilum would increase.
Parasites & vectors.Parasit Vectors.2013 Jun 20;6(1):187. [Epub ahead of print]
BACKGROUND: Understanding the variation in prevalence of Borrelia burgdorferi sensu lato (Lyme Borreliosis Spirochaetes, LBS) and A. phagocytophilum (causing tick-borne fever in ruminants and human granulocytic ehrlichiosis) in ticks is vital from both a human and an animal disease perspective to ta
PMID 23786850

Japanese Journal

Serologic and molecular detection of Ehrlichia chaffeensis and Anaplasma phagocytophila (human granulocytic Ehrlichiosis agent) in Korean patients

HEO E. J.
J. Clin. Microbiol. 40, 3082-3085, 2002
NAID 30021103383

PCR detection of Borrelia burgdorferi sensu lato, tick-borne encephalitis virus, and the human granulocytic ehrlichiosis agent in Ixodes persulcatus ticks from Western Siberia, Russia

MOROZOVA O. V.
J. Clin. Microbiol. 40, 3802-3804, 2002
NAID 30021103346

Direct cultivation of the causative agent of human granulocytic ehrlichiosis

GOODMAN J. L.
N Engl J Med 334(4), 209-215, 1996
NAID 30022546975

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★リンクテーブル★

リンク元	「ヒト顆粒球エーリキア症」「ヒト顆粒球エールリヒア症」「ヒト顆粒球エールリッヒア症」「ヒト顆粒球性エールリッヒア症」「HGE」
関連記事	「human」「Ehrlichiosis」「granulocytic」

「ヒト顆粒球エーリキア症」

Human granulocytic anaplasmosis
	Classification and external resources
ICD-10	A79.8
ICD-9	083.8
DiseasesDB	31663
MedlinePlus	001381
eMedicine	med/3391 ped/655 emerg/159
MeSH	D016873