Anaplasmosis

What is anaplasmosis?

Anaplasmosis (pronounced “an-uh-plas-MOH-sis”) is an illness you get from Anaplasma phagocytophilum, a type of bacteria. It spreads through the bite of infected ticks.

Symptoms can start out mild and flu-like. But if you don’t treat it quickly, anaplasmosis can cause serious complications. Anaplasmosis is sometimes called human granulocytic anaplasmosis (HGA).

How common is anaplasmosis?

About 5,000 to 6,000 people get anaplasmosis every year in the U.S. While you can get it any time of the year, it’s most common in June, July, October and November. These are times when blacklegged ticks are most active.

What are the symptoms of anaplasmosis?

Symptoms of anaplasmosis include:

• Fever.
• Chills.
• Headache.
• Muscle pain or soreness.
• Tiredness.
• Nausea and vomiting.
• Stomach pain.
• Rash (rare).

Symptoms start within a week or two of a tick bite. Without treatment, you may start experiencing additional symptoms, like confusion or seizures.

What causes anaplasmosis?

The bacteria Anaplasma phagocytophilum (A. phagocytophilum) causes anaplasmosis. You get it from the bite of blacklegged (deer) ticks and western blacklegged ticks. These ticks live in most parts of the U.S.

A. phagocytophilum reproduces inside ticks after the ticks bite infected deer, mice, cows, horses or other animals. When the tick bites you, it spreads the bacteria to your body.

In rare cases, you can get anaplasmosis from a blood transfusion.

What are the risk factors for anaplasmosis?

While anyone can get anaplasmosis, you’re at higher risk of getting severely ill if you:

• Are older than 50.
• Have a compromised immune system (from HIV, cancer or other conditions, or from immunosuppressant medications).
• Aren’t treated within the first few days of symptoms.

What are the complications of anaplasmosis?

If you don’t get treatment quickly enough or if you have a compromised immune system, you can have serious complications of anaplasmosis. They include:

• Acute respiratory distress syndrome (ARDS).
• Respiratory failure.
• Renal failure (acute kidney injury).
• Internal bleeding (hemorrhaging).
• Brain inflammation (meningoencephalitis).

How is anaplasmosis diagnosed?

The best way to diagnose anaplasmosis is with a bacterial culture (growing bacteria from a sample of your blood or other body fluid). Growing bacteria can take several weeks, so your provider will probably have to decide whether to treat you for anaplasmosis before the results are back.

In the meantime, they can make an initial diagnosis based on:

• Your symptoms and health history.
• A physical exam.
• Whether you’ve recently (within the past three weeks) been in an area where you could’ve been bitten by a tick, even if you don’t remember being bitten.
• Blood counts and other blood tests that provide results more quickly than cultures (but might be less accurate).

What specific tests diagnose anaplasmosis?

Blood tests can confirm an anaplasmosis diagnosis. Your provider will take a sample of your blood from your arm with a small needle. They’ll send it to a lab to perform tests, which might include:

• Complete blood count. Providers look for differences in the amount of blood cells you have compared to what they’d expect in someone without anaplasmosis.
• PCR tests. Polymerase chain reaction (PCR) tests can detect even small amounts of genetic code (DNA or RNA) in a sample. Providers can use PCR tests to see if there are signs of the bacteria’s DNA in your blood.
• Serology. This test looks for antibodies to the bacteria that cause anaplasmosis.
• Bacterial culture. Providers use this test to try to grow bacteria from your blood sample.

How is anaplasmosis treated?

Healthcare providers treat anaplasmosis with the antibiotic doxycycline. You usually have to take it for seven to 10 days.

Can anaplasmosis be prevented?

Avoiding tick bites is the best way to reduce your risk of anaplasmosis. Some ways to protect yourself include:

• Keep grass cut shorter than five inches.
• Stay on cleared paths while in wooded areas.
• Use bug sprays with DEET or other ingredients approved to keep ticks away.
• Cover as much of your skin as possible — for instance, with long sleeves, long pants and socks — when you’re in the woods or areas with long grass. You can buy clothing pre-treated with tick-repellant if you’re often in areas with ticks.
• Check yourself for ticks after you’ve been outside. Don’t forget your groin area, armpits and other areas you might not usually notice. If possible, have someone else check you in places you can’t see yourself (like your back and scalp).
• Ask your veterinarian about the best way to protect your pets from ticks. Check your pets for ticks often, especially after they’ve been outside.
• Follow directions for safely removing a tick if you find one on you.

What can I expect if I have anaplasmosis?

Most people make a full recovery from anaplasmosis without serious complications if they’re treated soon after symptoms start. Depending on how sick you are, you may need treatment in a hospital.

How long are you sick with anaplasmosis?

If you start antibiotics soon after you notice symptoms, you should begin to feel better within 24 to 48 hours. Continue taking antibiotics for as long as your provider prescribes, even after you feel better.

Does anaplasmosis ever go away?

Anaplasmosis can go away with antibiotics, but it might take a few weeks to feel completely better.

What’s the outlook for people with anaplasmosis?

The mortality (death) rate of anaplasmosis is about 0.5%, or 1 in every 200 people who have it. The rate may be higher in people with compromised immune systems.

When should I see my healthcare provider?

If you’ve been bitten by a tick — or have been in an area with ticks — and have symptoms of anaplasmosis, see a healthcare provider right away.

Also, talk to a healthcare provider if you’ve been bitten by a tick but don’t have symptoms. While taking antibiotics when you’re not sick won’t help prevent anaplasmosis, a provider can tell you:

• If you should take preventive antibiotics for other tick-borne illnesses.
• What symptoms to keep an eye out for.
• When to follow up with them or another provider.

When should I go to the ER?

Go to the nearest ER if you have signs of serious illness, including:

• Fever over 103 degrees Fahrenheit or 40 degrees Celsius.
• Coughing up blood.
• Severe shortness of breath.
• Confusion or other mental changes.
• Severe stomach (abdominal) pain.
• Seizures.

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• How do I take my medication?
• What medications can I take at home for my symptoms?
• What new or worsening symptoms should I look out for?
• How soon should I feel better?
• When should I follow up with you?

Are anaplasmosis and Lyme disease the same?

No, anaplasmosis and Lyme disease are different illnesses. You can get either one from bacteria spread through tick bites. But Borrelia burgdorferi bacteria cause Lyme and Anaplasma phagocytophilum bacteria cause anaplasmosis.

A note from Cleveland Clinic

Flu-like symptoms can be a sign of many illnesses — and most of them aren’t caused by tick bites. But if it’s summertime, nothing else is going around and you’ve recently been in an area where there could’ve been ticks, talk to a healthcare provider. They can help you understand what kinds of tests and treatment you might need, or if you just need to keep an eye on your symptoms and make a follow-up appointment.