Anaplasmosis
OVERVIEW OF Anaplasmosis :
It is the tick borne disease caused by the bacterium Anaplasma phagocytophillum.The vector for this bacterium is the tick which are called as Ixodes scapularis and Ixodes pacificus.Anaplasmosis is also known as Human Granulocytic Echricolosis.(HCG).The Incubation period is 5-14 days.
EPIDEMIOLOGY :
It can occur at any age.But common age group is 40yrs.Men are mostly affected tham women.It is more common among the northwest population.
Epidemiological Data should be collected.Questionnaire such as recent travel to endemic areas,occupational exposure with ticks,expose to the wooden materials should be considered.
ROUTES OF TRANSMISSION :
The tick plays an vital role in the transmission of the disease.
DIAGNOSTIC :
- Examination of your white blood cells under a microscope.:The bacteria can often be seen inside these white blood cells.Changes in the mononuclear cells is also seen.leucocytopenia can be visualized in response to the bacterial infection.
- Peripheral Blood Smear:It shows leucopenia(reduction in the number of white blood cells) and thrombocytopenia(reduction in the number of platelets).Presence of intracytoplasmic inclusion bodies is the rapid method in diagnosing the human granulocytic anaplasmosis.
- Polymerase chain reaction (PCR): This is a newer method to detect the multiplication of the bacteria and it is used to amplify the bacterial DNA.
- Antibody test. This often does not become positive until many days or a few weeks after the infection. It is usually not helpful while you are first sick.
- Immunohistochemical staining Test:It is used in bone marrow,lymph node and spleen.Immunostaining of bone marrow shows the Anaplasmosis phagocytophilum infection
- Indirect Immunofluorescent antibody test:This test detects the antibodies such as IgM developed in response to the anaplasmosis.This test shows negative in 1 st week of illness.Hence subsequent serum sample should be collected in further weeks for the detection of antibodies
- Liver function test:Elevation od aspartate transaminase,elevated lactate dehydrogenase and C Reactive protein is seen.
TREATMENT AND PROGNOSIS :
.Oral administration of antibiotics.
IV infusion to balance the electrolyte in the system.
PROGNOSIS :
The prognosis of anaplasmosis is better when it is diagnosed at an early stages and fatality rate is low in anaplasmosis.
PREVENTION :
- Avoid wooded and bushy areas with high grass and leaf litter
- Wear light-colored long pants and long-sleeved shirts, and enclosed shoes. Tuck your pants into your socks while out hiking.
- Use tick repellents such as DEET(N diethyl meta tolumide) or permethrin on exposed skin and clothing.
- Do a full-body check for ticks after coming in from the outdoors.
- Bathe or shower within a couple of hours after coming indoors, so you can wash off and more easily find and remove any ticks.
- Examine gear and pets for ticks.
- Tumble clothes in a dryer on high heat to kill any remaining ticks.
If you do find a tick attached to your skin, remove it within 24 hours. Follow these steps:
- Use a pair of tweezers to grasp the tick directly by the head or mouth parts. Don't grab the tick by its body.
- Remove the tick by pulling it out firmly and directly outward without twisting or turning.
- Place the tick in alcohol to kill it.
- Clean the bite wound with a disinfectant.
Take a photo of the tick. This can help identify the type of tick if you have symptoms.
Recovery Period :
The duration of the treatment includes 10-14 days.Anaplasmosis is a self limiting disease.The case fatality rate of the patient suffering from anaplasmosis is less than 1%.
Medicines used in the Treatment :
Tetracycline group of drugs such as doxycycline is the first drug of choice in the treatment of Anaplasmosis.
Doxycycline (100mg)prevents the serious illness when it is given at earlier stages.
In pregnancy and children Chloramphenicol is indicated in treating the anaplasmosis.
Rifampicin can be used as an alternative to doxycycline allergy patients and in pregnant women
Permethrin is also used in the treatment for anaplasmosis
Imidocarb:but this drug is not used in some countries.
Resistance to doxycycline is not detected till present date