Ehrlichiosis

What is ehrlichiosis?

Ehrlichiosis is a bacterial infection that infects animals, such as dogs, deer, coyotes, and mice. Sometimes the disease spreads to humans.

How does it occur?

People can become infected when they are bitten by a tick. If a tick bites an animal infected with ehrlichiosis and then bites you, you may become infected. The infection does not spread from person to person. In the US, the disease occurs mainly in the southeastern and south central regions of the country.

What are the symptoms?

The symptoms of ehrlichiosis vary. They may appear within several days to 3 weeks of a tick bite. In most cases the symptoms are mild flulike or coldlike symptoms, such as:

• muscle aches
• tiredness
• headache
• fever
• chills.

Sometimes the symptoms include:

• nausea
• vomiting
• cough
• joint pain
• confusion.

Unlike some other infections spread by ticks, the infection does not usually cause a rash.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and your history of exposure to ticks. He or she will examine you. You may have some blood tests. If your blood tests show a low white blood cell count, low platelets, or abnormal liver tests, it is more likely that you have ehrlichiosis. There are 2 specialized tests available in some labs that can give additional evidence for ehrlichiosis infection. These blood tests look for the genes of the ehrlichiosis bacteria and for antibodies in your blood to the bacteria.

Because early treatment can prevent complications from the infection, treatment is often begun before you have the test results.

How is it treated?

Ehrlichiosis is treated with antibiotics, usually for 7 to 10 days. If your symptoms are severe, you may be treated in the hospital.

How long will the effects last?

Without treatment, the symptoms of ehrlichiosis may last for up to 2 months. Once you start taking antibiotics, you will usually start feeling better in a couple of days.

Rarely, especially without prompt treatment, the infection can become severe and life threatening, causing serious complications such as infection in the brain, seizures, or heart failure.

How can I take care of myself?

Take your medicines just as prescribed by your healthcare provider. Get plenty of rest.

Call your healthcare provider if:

• Your symptoms are not getting better after at least 2 days of antibiotics.
• Your symptoms are getting worse even though you have started taking antibiotics.
• You have finished your antibiotics and keep having symptoms.
• You start to have symptoms again after finishing your antibiotics.

How can I help prevent ehrlichiosis?

Because ehrlichiosis is spread by ticks, the best way to avoid getting it is to avoid getting bitten by ticks. If you are bitten, remove the tick as soon as possible.

• Be aware of the areas where ticks live. Do not walk, camp, or hunt in the woods of tick-infested areas without precautions. In areas of thick underbrush, try to stay near the center of trails.
• When you are outdoors, wear long-sleeved shirts tucked into your pants. Wear long pants tucked into your socks or boot tops if possible. A hat may help, too. Wearing light-colored clothing may make it easier to spot the small tick before it reaches your skin and bites.
• Use approved tick repellents on exposed skin and clothing. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it on your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
  • Adults should use products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your body when you go back indoors.
  • Picaridin may irritate the skin less than DEET and appears to be just as effective.
  • Spray clothes with repellents because insects may crawl from clothing to the skin or bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
• Treat household pets for ticks and fleas. Check pets after they've been outdoors.
• Brush off clothing and pets before entering the house.
• After you have been outdoors, undress and check your body for ticks. They usually crawl around for several hours before biting. Check your clothes, too. Wash them right away to remove any ticks.
• Shower and shampoo after your outing.
• Inspect any gear you have carried outdoors.
• Remove an attached tick with tweezers by gripping the tick as close to your skin as possible and gently pulling it straight away from you until it releases its hold. Don't twist the tick as you pull, and don't squeeze its body. Thoroughly wash your hands and the bite area and apply an antiseptic such as rubbing alcohol.
• If you spend much time hiking, you may want to include a pair of tick tweezers in your first-aid kit. The tweezers are available at many sporting goods stores.