Estudos de soroprevalência
Os estudos de soroprevalência em populações assintomáticas revelaram a presença de anticorpos antierliquiais ou anticorpos de antianaplasma em crianças e adultos. Em algumas áreas endêmicas, a soroprevalência varia de 2% a 22% (erliquiose monocitotrópica/monocítica humana [EMH]) e de 15% a 36% (anaplasmose granulocitotrópica/granulocítica humana [AGH]). Esses casos representam mais provavelmente infecções pregressas com Ehrlichia patogênica ou exposição à Ehrlichia não patogênica através da picada de carrapatos.[24]Bakken JS, Goellner P, Van Etten M, et al. Seroprevalence of human granulocytic ehrlichiosis among permanent residents of northwestern Wisconsin. Clin Infect Dis. 1998 Dec;27(6):1491-6.
http://www.ncbi.nlm.nih.gov/pubmed/9868666?tool=bestpractice.com
[74]Comer JA, Nicholson WL, Olson JG, et al. Serologic testing for human granulocytic ehrlichiosis at a national referral center. J Clin Microbiol. 1999 Mar;37(3):558-64.
https://journals.asm.org/doi/10.1128/JCM.37.3.558-564.1999
http://www.ncbi.nlm.nih.gov/pubmed/9986812?tool=bestpractice.com
[114]Bakken JS, Krueth J, Tilden RL, et al. Serological evidence of human granulocytic ehrlichiosis in Norway. Eur J Clin Microbiol Infect Dis. 1996;15:829-832.
http://www.ncbi.nlm.nih.gov/pubmed/8950565?tool=bestpractice.com
[115]Dumler JS, Dotevall L, Gustafson R, et al. A population-based seroepidemiologic study of human granulocytic ehrlichiosis and Lyme borreliosis on the west coast of Sweden. J Infect Dis. 1997;175:720-722.
http://www.ncbi.nlm.nih.gov/pubmed/9041353?tool=bestpractice.com
[116]Brouqui P, Dumler JS. Serologic evidence of human monocytic and granulocytic ehrlichiosis in Israel. Emerg Infect Dis. 2000;6:314-315.
http://www.ncbi.nlm.nih.gov/pubmed/10827125?tool=bestpractice.com
[117]Heo EJ, Park JH, Koo JR, et al. Serologic and molecular detection of Ehrlichia chaffeensis and Anaplasma phagocytophila (human granulocytic ehrlichiosis agent) in Korean patients. J Clin Microbiol. 2002 Aug;40(8):3082-5.
https://journals.asm.org/doi/10.1128/JCM.40.8.3082-3085.2002
http://www.ncbi.nlm.nih.gov/pubmed/12149387?tool=bestpractice.com
[118]Park JH, Heo EJ, Choi KS, et al. Detection of antibodies to Anaplasma phagocytophilum and Ehrlichia chaffeensis antigens in sera of Korean patients by western immunoblotting and indirect immunofluorescence assays. Clin Diagn Lab Immunol. 2003 Nov;10(6):1059-64.
https://journals.asm.org/doi/10.1128/CDLI.10.6.1059-1064.2003
http://www.ncbi.nlm.nih.gov/pubmed/14607867?tool=bestpractice.com
[119]Guillaume B, Heyman P, Lafontaine S, et al. Seroprevalence of human granulocytic ehrlichiosis infection in Belgium. Eur J Clin Microbiol Infect Dis. 2002;21:397-400.
http://www.ncbi.nlm.nih.gov/pubmed/12072927?tool=bestpractice.com
[120]Heppner DG, Wongsrichanalai C, Walsh DS, et al. Human ehrlichiosis in Thailand. Lancet. 1997;350:785-786.
http://www.ncbi.nlm.nih.gov/pubmed/9298007?tool=bestpractice.com
As populações assintomáticas não são rastreadas, pois essa é uma doença aguda sem evolução crônica conhecida em humanos, ao contrário dos hospedeiros zoonóticas, nos quais as infecções crônicas são uma regra.