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Epidemiology

Ehrlichiosis is a nationally notifiable diseases in the United States. There have been cases reported in every month of the year, but most cases are reported during April-September. ^[1] These months are also the peak months for tick activity in the United States.

From 2008-2012, the average yearly incidence of ehrlichiosis was 3.2 cases per million persons. This is more than twice the estimated incidence for the years 2000-2007. ^[2] The incidence rate increases with age, with the ages of 60-69 years being the highest age-specific years.Children of less than 10 years and adults aged 70 years and older have the highest case-fatality rates. ^[2] There is a documented higher risk of death among persons who are immunosuppressed. ^[3]

^ Biggs, Holly M.; Behravesh, Casey Barton; Bradley, Kristy K.; Dahlgren, F. Scott; Drexler, Naomi A.; Dumler, J. Stephen; Folk, Scott M.; Kato, Cecilia Y.; Lash, R. Ryan (2016-01-01). "Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States". MMWR. Recommendations and Reports. 65 (2): 1–44. doi:10.15585/mmwr.rr6502a1. ISSN 1057-5987.
^ ^a ^b Nichols KH, Dahlgren FS, Drexler NA, Massung RF, Behravesh CB. Increasing incidence of ehrlichiosis in the United States: a summary of national surveillance of Ehrlichia chaffeensis and Ehrlichia ewingiiinfections in the United States, 2008–2012. Am J Trop Med Hyg 2016;94:52–60.
^ Dahlgren FS, Mandel EJ, Krebs JW, Massung RF, McQuiston JH. Increasing incidence of Ehrlichia chaffeensis and Anaplasma phagocytophilum in the United States, 2000–2007. Am J Trop Med Hyg 2011;85:124–31.

[1] Biggs, Holly M.; Behravesh, Casey Barton; Bradley, Kristy K.; Dahlgren, F. Scott; Drexler, Naomi A.; Dumler, J. Stephen; Folk, Scott M.; Kato, Cecilia Y.; Lash, R. Ryan (2016-01-01). "Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States". MMWR. Recommendations and Reports. 65 (2): 1–44. doi:10.15585/mmwr.rr6502a1. ISSN 1057-5987.

[:0-2] Nichols KH, Dahlgren FS, Drexler NA, Massung RF, Behravesh CB. Increasing incidence of ehrlichiosis in the United States: a summary of national surveillance of Ehrlichia chaffeensis and Ehrlichia ewingiiinfections in the United States, 2008–2012. Am J Trop Med Hyg 2016;94:52–60.

[3] Dahlgren FS, Mandel EJ, Krebs JW, Massung RF, McQuiston JH. Increasing incidence of Ehrlichia chaffeensis and Anaplasma phagocytophilum in the United States, 2000–2007. Am J Trop Med Hyg 2011;85:124–31.

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