Ehrlichiosis

Ehrlichiosis is a tick-borne bacterial disease characterized by flu-like condition.

Symptoms start appearing within 5-7 days of tick bite and range from mild to severe.

This bacterial illness affects several mammals like mice, cattle, deer, and horses. The bacterium resembles Rickettsia and infects white blood cells.

There are three different species of Ehrlichia that infects humans

• Ehrlichia chaffeensis,
• Ehrlichia ewingii,
• and Ehrlichia muris-like.

These bacteria are transmitted by the vector, lone star tick. Ehrlichiosis is diagnosed on the basis of symptoms and tests. The infection is treated with antibiotics. 

Symptoms of ehrlichiosis appear within a week or two of tick bite. The most common symptoms of the disease are

• Low-grade fever
• Headache
• Fatigue
• Weakness
• Lack of appetite
• Pain in joints
• Confusion
• Rashes on skin
• Cough
• Muscle aches
• Chills
• Confusion
• Vomiting
• Diarrhea

In some people the symptoms may be so mild that it is ignored. But when left untreated, the symptoms may lead to more serious conditions.

Severe symptoms include difficulty in breathing or bleeding disorders.

Ehrlichiosis is caused by infection of bacteria Ehrlichia that is transmitted by lone star ticks. There are three different species of Ehrlichia that infects humans

• Ehrlichia chaffeensis,
• Ehrlichia ewingii,
• and Ehrlichia muris-like.

Ticks get the bacteria from another infected host like deer, coyote, or cattle. Ticks feed on the blood and while doing so pass on the bacteria to another host, including human.

The bacteria gains access into the skin through the site of tick bite. The infectious bacteria then moves to the blood stream. Bacteria is usually transmitted when the tick has been feeding for a duration of 24 hours. Bacteria may also be transmitted through blood transfusions from an infected person, from mother to fetus, and through direct contact with a slaughtered animal.

The major risk factors of ehrlichiosis are being in a place where the vector is prevalent, particularly during summer and spring. Population of the tick is high during this time and increase chances of tick exposure. Ehrlichiosis is more common among males when compared to women.

Symptoms of ehrlichiosis resemble that of many other common conditions, making confirmatory diagnosis hard.

Further, tick bite is very inconspicuous and many people may not remember being bitten by the vector.

History of exposure is the best indicator of bacterial infection.

• Blood tests reveal low white blood cell and platelet count.
• Liver function tests also show abnormality.
• Polymerase chain reaction (PCR) and indirect fluorescent antibody (IFA) test are the specific tests used in diagnosis.
• PCR helps to identify specific genes that indicate ehrlichiosis.
• IFA is used to measure the amount of antibodies that cause ehrlichiosis. 

Antibiotic doxycycline is the recommended medication for treating ehrlichiosis.

Antibiotics are usually started even before the lab results are obtained, particularly if the person has any of the risk factors for the disease.

Rifampin is suggested for children and pregnant women as they are unable to take doxycycline. 

Avoiding tick bites is the ideal way to prevent ehrlichiosis. The tick attaches to the body while working or walking in fields or grass.

It moves upwards and burrows into skin in other parts of the body. It is usually found attached at the back of knee, behind ears, underarms, and at the back of neck.

Removing the tick within a day of their attachment help to prevent the disease. If you are visiting an area where the vector is present, taking adequate precautions help to prevent infection.

Some simple methods to prevent the condition are

• Wearing light-colored dress
• Wearing closed shoes or boots
• Applying insect repellants to avoid insect bites
• Opting for long pants and shirts with long sleeves
• Walking on open or clear fields
• Checking for ticks after being outdoors for sometime
• Cleaning pets after they have been outdoors

Some of the alternative remedies for ehrlichiosis include the use of ginger, licorice, and other anti-bacterial products and foods.

Ginger and licorice helps to improve the functioning of immune system and to improve the measure of white blood cells in the body. 

Your lifestyle will be greatly affected by ehrlichiosis if you do not pursue treatment as soon as possible.

The tick should be removed within 24 hours to prevent the disease.

Use small tweezers to remove the tick that is stuck on the body. Remove the tick while taking care to pull it out along with the mouthparts that is stuck in the skin.

Cleanse the bite site with an antiseptic and observe the bite site to look out for any allergic reactions in the site. 

If left untreated, ehrlichiosis may lead to serious complications like kidney failure, respiratory failure, heart failure, seizures, and coma.

The risk of complication is more among people with weakened immune system.