Ehrlichia chaffeensis Seroprevalence Among Children in the Southeast and South-Central Regions of the United States | Infectious Diseases | JAMA Pediatrics | JAMA Network
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Article
February 2002

Ehrlichia chaffeensis Seroprevalence Among Children in the Southeast and South-Central Regions of the United States

Author Affiliations

From the Divisions of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, Ky (Dr Marshall), and the University of Arkansas for Medical Sciences, Little Rock (Drs Jacobs and Schutze); PanBio InDx, Inc, Baltimore, Md (Ms Paxton); the Divisions of Pediatric Infectious Diseases, University of Tennessee Health Sciences Center, Memphis (Drs Buckingham and DeVincenzo), the University of Missouri, Kansas City (Dr Jackson), and the University of Oklahoma Health Sciences Center, Oklahoma City (Dr San Joaquin); Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tenn (Dr Standaert); and Division of Pediatric Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Woods).

Arch Pediatr Adolesc Med. 2002;156(2):166-170. doi:10.1001/archpedi.156.2.166
Abstract

Background  The reported annual incidence of human monocytic ehrlichiosis, which is due to infection with Ehrlichia chaffeensis, is as high as 5.5 per million in some states, but serosurveys suggest much higher infection rates in some populations.

Objective  To estimate the prevalence of E chaffeensis infection among children aged 1 to 17 years living in the southeast and south-central United States.

Design  Cross-sectional serosurvey.

Setting  Seven academic pediatric medical centers in the southeastern and south-central United States.

Patients  Nineteen hundred ninety-nine children (approximately 300 at each center) having their blood drawn for any reason.

Main Outcome Measure  The presence of antibody at 2 different cutoff titers to E chaffeensis, as detected by indirect immunofluorescence assay.

Results  Overall, 250 children (13%) had E chaffeensis antibody titers of 1:80 or higher and 61 (3%) had titers of 1:160 or higher. Age-adjusted seroprevalence rates varied widely between sites. At 1:80 or higher, the highest rate was in Winston-Salem, NC (22%), and the lowest was in Louisville, Ky (2%). At 1:160 or higher, the highest rate was in Kansas City, Mo (9%), and the lowest was in Oklahoma City, Okla (<1%). In univariate analyses, no associations were found between seroprevalence at either cutoff value and sex, race, source of specimen, or residence demographics. However, age was a significant predictor of seroprevalence at both cutoff values. In multiple logistic regression analysis, study site and age remained strong predictors of seroprevalence, but living in a nonurban ZIP code was not significantly related.

Conclusion  Infection with E chaffeensis, or related ehrlichiae, may be more common in children than previously recognized.

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