Nosocomial Transmission of Human Granulocytic Anaplasmosis in China

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Abstract
Human granulocytic anaplasmosis (HGA) is an emerging tick-borne infectious disease that was recognized in the United States in 19901 and in Europe in 1997.2 The disease name was changed from human granulocytic ehrlichiosis to HGA in 2001 when the causative rickettsia was reclassified from the genus ehrlichia as Anaplasma phagocytophilum.3 Although the clinical presentation of HGA is variable and although it may be difficult to diagnose, the annual number of infections reported in the United States since 1990 has steadily increased.4,5 Seroepidemiological data suggest that infection rates in endemic areas are as high as 15% to 36%,6-8 implying that the diagnosis is often missed or that infection is mild or asymptomatic. Because epidemiological, clinical, and microbiological information about HGA is limited, the disease is likely underrecognized and underreported worldwide.7