Biomedical subjects

J E Dawson

Publications and source records attributed to J E Dawson.

At least 19 recordsLinked to original sources

PubMed2001

Tissue diagnosis of Ehrlichia chaffeensis in patients with fatal ehrlichiosis by use of immunohistochemistry, in situ hybridization, and polymerase chain reaction.

In the United States, human ehrlichiosis is a complex of emerging tick-borne diseases caused by 3 distinct Ehrlichia species: Ehrlichia chaffeensis, Ehrlichia ewingii, and the human granulocytotropic ehrlichiosis agent. Ehrlichioses are characterized by a mild to severe illness, and approximately 4% of cases are fatal. Because these obligate intracellular bacteria are difficult to resolve with routine histologic techniques, their distribution in tissues has not been well described. To facilitate the visualization and detection of ehrlichiae, immunohistochemistry (IHC), in situ hybridization (ISH), and polymerase chain reaction (PCR) assays were developed by use of tissues from 4 fatal cases of E. chaffeensis infection. Evidence of E. chaffeensis via IHC, ISH, and PCR was documented in all 4 cases. Abundant immunostaining and in situ nucleic acid hybridization were observed in spleen and lymph node from all 4 patients. Significantly, in 2 of these patients, serologic evidence of infection was absent. Use of IHC, ISH, and PCR to visualize and detect Ehrlichia in tissues can facilitate diagnosis of ehrlichial infections.

Adult↗

PubMed2001

Persistent Ehrlichia chaffeensis infection in white-tailed deer.

Four white-tailed deer (Odocoileus virginianus) were inoculated intravenously with a deer-origin isolate (15B-WTD-GA) of Ehrlichia chaffeensis. The course of infection was monitored using indirect fluorescent antibody (IFA), polymerase chain reaction (PCR), and culture over a 9 m period. All deer became rickettsemic within 24 days post inoculation (DPI), and all developed antibody titers >1:64 to E. chaffeensis by 17 DPI. Titers in all deer fell below 1:64 during 87 to 143 DPI. One deer exhibited a second period of seropositivity (peak titer of 1:256) from 207 to 271 DPI but was culture and PCR negative during this period. Rickettsemia was confirmed by reisolation of E. chaffeensis as late as 73 to 108 DPI in three deer. Positive PCR results were obtained from femur bone marrow of one deer and from rumenal lymph node of another (leer at 278 DPI. None of the deer developed clinical signs, hematologic abnormalities, or gross or microscopic lesions attributable to E. chaffeensis. Two uninoculated control deer were negative on all tests through 90 DPI at which time they were removed from the study. Herein we confirm that white-tailed deer become persistently infected with E. chaffeensis, have initial rickettsemias of several weeks duration and may experience recrudescence of rickettsemia, which reaffirm the importance of deer in the epidemiology of E. chaffeensis.

Animals↗

PubMed2000

Influenza A virus infection complicated by fatal myocarditis.

Influenza virus typically causes a febrile respiratory illness, but it can present with a variety of other clinical manifestations. We report a fatal case of myocarditis associated with influenza A infection. A previously healthy 11-year-old girl had malaise and fever for approximately 1 week before a sudden, witnessed fatal collapse at home. Autopsy revealed a pericardial effusion, a mixed lymphocytic and neutrophilic myocarditis, a mild lymphocytic interstitial pneumonia, focal bronchial/bronchiolar mucosal necrosis, and histologic changes consistent with asthma. Infection with influenza A (H3N2) was confirmed by virus isolation from a postmortem nasopharyngeal swab. Attempts to isolate virus from heart and lung tissue were unsuccessful. Immunohistochemical tests directed against influenza A antigens and in situ hybridization for influenza A genetic material demonstrated positive staining in bronchial epithelial cells, whereas heart sections were negative. Sudden death is a rare complication of influenza and may be caused by myocarditis. Forensic pathologists should be aware that postmortem nasopharyngeal swabs for viral culture and immunohistochemical or in situ hybridization procedures on lung tissue might be necessary to achieve a diagnosis. Because neither culturable virus nor influenza viral antigen could be identified in heart tissue, the pathogenesis of influenza myocarditis in this case is unlikely to be the result of direct infection of myocardium by the virus. The risk factors for developing myocarditis during an influenza infection are unknown.

Antigens, Viral↗

PubMed1999

Novel Ehrlichia organism (Rickettsiales: Ehrlichieae) in white-tailed deer associated with lone star tick (Acari: Ixodidae) parasitism.

Polymerase chain reaction (PCR) evidence of a novel Ehrlichia organism was found recently in wild white-tailed deer, Odocoileus virginianus Zimmermann, and lone star ticks, Amblyomma americanum L., from the southeastern United States. To evaluate whether lone star tick parasitism was associated with the presence of this novel Ehrlichia organism in deer, 2 retrospective studies were conducted using specific nested PCR to test archived deer serum samples. The 1st study of 150 serum samples collected from a single deer population over a 15-yr period examined the temporal association between the presence of the Ehrlichia organism in deer and parasitism by lone star ticks. The deer Ehrlichia was not detected in serum samples collected before 1986, when lone star ticks were absent or rare, but was detected in samples collected in 1986 and every year thereafter, when lone star ticks became increasingly abundant. In the 2nd study, serum samples from 120 deer from 24 sites in 14 southeastern states were tested to evaluate if a site-specific, spatial association existed between the presence of the deer Ehrlichia and lone star ticks. All 60 serum samples from the 12 deer populations without evidence of lone star tick infestation were negative for the deer Ehrlichia, whereas 83% of the 12 populations infested by lone star ticks had PCR evidence of infection. These data suggest that lone star ticks may be a vector of the deer Ehrlichia; however, they do not preclude the involvement of other arthropods in maintaining infection with this organism in deer populations.

Animals↗

PubMed1998

Duration of tick attachment required for transmission of granulocytic ehrlichiosis.

Deer tick-transmitted pathogens such as Lyme disease spirochetes and babesiae appear to require a period of reactivation and replication during the tick's blood meal before it is able to infect a host. The duration of nymphal tick attachment that is required for transmission of the agent of human granulocytic ehrlichiosis (HGE) was determined by removing feeding ticks from mice at various time points. As with spirochetes and babesiae, ehrlichiae infected few mice when ticks were removed prior to 36 h of tick attachment. This "grace period" may serve as a modifying factor in the epidemiology of this newly emergent zoonosis and help physicians make informed decisions concerning management of tick bites in HGE-endemic areas.

Animals↗

PubMed1998

A single tissue culture system for the propagation of the agents of the human ehrlichioses.

Two newly emergent human diseases found in the United States, human monocytotropic ehrlichiosis (HME) and human granulocytotropic ehrlichiosis (HGE), are caused by pathogens of the genus Ehrlichia. The causative agent of HGE can be propagated in HL-60 human promyelocytic leukemia cells. Herein, we report the development of a method to propagate E. chaffeensis, the causative agent of HME, in HL-60 cells, thus providing a common system for the study of both species. The continuous propagation of E. chaffeensis requires the induction of HL-60 differentiation along the monocytic pathway toward phenotypically mature macrophages by the addition of 25-OH vitamin D3 to the growth medium.

Animals↗

PubMed1998

Lack of seroreactivity to Ehrlichia chaffeensis among rodent populations.

A retrospective serosurvey for antibodies to Ehrlichia chaffeensis was conducted on eight species of wild rodents (Mus musculus, Oryzomys palustris, Peromyscus leucopus, Rattus norvegicus, Reithrodontomys humulis, Sciurus carolinensis, Sciurus niger, and Sigmodon hispidus) from the southeastern United States. Serum samples (n = 281) collected between 1973 and 1993 were evaluated using an indirect fluorescent antibody test. All samples, screened at a dilution of 1:32, were negative for antibodies to E. chaffeensis. Sixty-three percent of the rodents tested were from areas where E. chaffeensis has been confirmed or is strongly suspected to be endemic. These data suggest limited or no involvement of rodents in the epidemiology of E. chaffeensis.

Animals↗

PubMed1998

Natural coinfection of a white-tailed deer (Odocoileus virginianus) population with three Ehrlichia spp.

The ticks Amblyomma americanum and Ixodes scapularis, strongly implicated vectors of Ehrlichia chaffeensis and the human granulocytic ehrlichiosis (HGE) agent, respectively, commonly are found on white-tailed deer (Odocoileus virginianus). As deer can be infected with E. chaffeensis, the HGE agent, and another Ehrlichia-like organism, a deer population parasitized by both tick species in coastal Georgia was tested for evidence of Ehrlichia spp. infection using serologic, molecular, and culture techniques. Antibodies to both E. chaffeensis (geometric mean titer = 111) and Ehrlichia equi, surrogate antigen for the HGE agent, (geometric mean titer = 1,024) were detected by indirect fluorescent antibody testing. Nested polymerase chain reaction employing species-specific primers demonstrated sequence-confirmed 16S rDNA fragments of 3 distinct Ehrlichia spp. in this population: E. chaffeensis (1/5), the HGE agent (3/5), and an Ehrlichia-like organism previously described from white-tailed deer (5/5). Ehrlichia chaffeensis was isolated in culture from the inguinal lymph node of a single deer. An Ehrlichia-type morula was identified in a neutrophil of 1 deer on examination of blood smears. This work provides the first evidence of the HGE agent in a nonhuman host in the southeastern United States and documents infection with both E. chaffeensis and the HGE agent in a single deer population, thereby supporting the importance of white-tailed deer in the natural history of the human ehrlichioses agents.

Animals↗

PubMed1997

Attempted transmission of human granulocytotropic Ehrlichia (HGE) by Amblyomma americanum and Amblyomma maculatum.

Transstadial transmission of human granulocytotrophic Ehrlichia (HGE) was attempted in dogs using Amblyomma americanum (L.) and A. maculatum Koch, two species that, as adults, feed readily on human beings. Larvae and nymphs were acquisition-fed on a dog that was parasitemic with HGE. Two months later, following digestion of the blood meal and subsequent molting to nymphal or adult stage, these ticks were fed to repletion on HGE-naive dogs. None of the dogs developed clinical evidence of ehrlichiosis. Parasites were not observed in blood smears by light microscopy, HGE DNA was not detected by polymerase chain reaction, and none of the dogs seroconverted. Based on this trial, we conclude that, unlike E. chaffeensis, HGE is probably not transmitted from dog to dog by either A. americanum or A. maculatum.

Animals↗

PubMed1997

Evaluation of indapamide 1.25 mg once daily in elderly patients with mild to moderate hypertension.

The objective of this study was to evaluate the safety and efficacy of indapamide 1.25 mg once daily as monotherapy in elderly patients (65 years and older) with mild to moderate essential hypertension. Two hundred and seventy-nine (279) elderly patients were enrolled in a washout period, during which patients received single-blind placebo for 4 weeks. Patients demonstrating supine diastolic pressures between 95 mm Hg and 114 mm Hg at the end of the 4-week placebo washout period were entered into the 8-week double-blind treatment period. Two hundred and four (204) patients qualified for the study and were randomized to the double-blind treatment; 103 patients received indapamide 1.25 mg and 101 patients received placebo for 8 weeks. Overall, 177 patients (92 indapamide and 85 placebo) completed the study. The primary efficacy criterion was the mean change in supine diastolic blood pressure (DBP) from double-blind baseline to the end of 8 weeks of therapy. By week 8 of the double-blind treatment period, indapamide 1.25 mg produced a statistically significant (P = 0.0037) decrease in supine DBP of 8.2 mm Hg compared to a decrease of 5.3 mm Hg produced in the placebo group. Additionally, indapamide 1.25 mg was statistically (P = 0.0028) more effective than placebo in reducing supine systolic BP (SBP) (-10.1 vs -4.2 mm Hg). The incidence of drug-related adverse events during the double-blind treatment period was similar between the two treatment groups. A low dose of indapamide, 1.25 mg, given once daily for 8 weeks was effective as monotherapy with respect to BP reduction in an elderly population with mild to moderate hypertension. Indapamide 1.25 mg was safe and generally well tolerated in this elderly patient population.

Aged↗

PubMed1997

Dogs infected with a human granulocytotropic Ehrlichia spp. (Rickettsiales: Ehrlichieae).

Dogs were found to be susceptible to human granulocytotropic Ehrlichia spp. Infection was produced through the bite of Ixodes scapularis Say (= dammini Spielman, Clifford, Piesman & Corwin) nymphs and adults that acquired infection while feeding as larvae on experimentally infected mice. Dogs were also infected by intravenous injection of mouse blood or dog blood from parasitemic donors. Parasites were demonstrable in neutrophils within 8 or 9 d after nymphs began feeding; prepatent periods were longer when infection was induced by adult tick feeding (18 d) or by transfusion of mouse blood (12 d). The shortest prepatent period observed was 5 d in a dog infected by transfusion of blood from a parasitemic dog. Infections in dogs were mild and apparently transient. Mild thrombocytopenia was the most commonly observed abnormality. Parasites could be detected by light microscopy during the acute phase of infection (4 or 5 d) and parasite DNA by polymerase chain reaction as early as 5 d after exposure but not at 6-9 d after morulae were first observed in neutrophils. Likewise, dog blood was infectious for mice at 2 d but not at 25 d, and for dogs at 3 d but not at 13 d after morulae were first observed in neutrophils. Seroconversion occurred as early as 11 d after onset of tick feeding and persisted until dogs were euthanatized. Gross and histopathologic lesions were similar to those observed in dogs with E. canis (Donatien & Lestoquard), E. chaffeensis Anderson, Dawson & Wilson, and E. ewingii Anderson, Greene, Jones & Dawson infections but were generally milder than any of these. The moderate enlargement of lymphoid organs observed grossly was reflected histologically as mild to moderate reactive hyperplasia, which was largely follicular (B cell).

Animals↗

PubMed1997

Isolation of Ehrlichia chaffeensis from wild white-tailed deer (Odocoileus virginianus) confirms their role as natural reservoir hosts.

Field and experimental studies have implicated white-tailed deer (Odocoileus virginianus) as probable reservoir hosts for Ehrlichia chaffeensis, the causative agent of human monocytic ehrlichiosis, but natural infection in deer has not been confirmed through isolation of E. chaffeensis. Thirty-five white-tailed deer collected from three Amblyomma americanum-infested populations in Georgia were examined for evidence of E. chaffeensis infection by serologic, molecular, cell culture, and xenodiagnostic methods. Twenty-seven deer (77%) had E. chaffeensis-reactive indirect fluorescent-antibody assay titers of > or = 1:64; and the blood, spleens, or lymph nodes of seven (20%) deer were positive in a nested PCR assay with E. chaffeensis-specific primers. E. chaffeensis was isolated in DH82 cell cultures from the blood of five (14%) deer, including two deer that were PCR negative. Combination of culture and PCR results indicated that six (17%) deer were probably rickettsemic and that nine (26%) were probably infected. Restriction digestion of PCR products amplified from deer tissues and cell culture isolates resulted in a banding pattern consistent with the E. chaffeensis 16S rRNA gene sequence. The sequences of all PCR products from deer tissues or cell culture isolates were identical to the sequence of the Arkansas type strain of E. chaffeensis. Xenodiagnosis with C3H mice inoculated intraperitoneally with deer blood, spleen, or lymph node suspensions was unsuccessful. When viewed in the context of previous studies, these findings provide strong evidence that E. chaffeensis is maintained in nature primarily by a tick vector-vertebrate reservoir system consisting of lone star ticks and white-tailed deer.

Animals↗

PubMed1997

Development and evaluation of a recombinant antigen, monoclonal antibody-based competitive ELISA for heartwater serodiagnosis.

Cowdria ruminantium is the etiologic agent of heartwater, a tick-transmitted foreign animal disease with considerable potential for entrance into the USA. A competitive enzyme-linked immunosorbent assay (cELISA) was developed to detect serologic responses to C. ruminantium infection. The cELISA utilized a recombinant form of the C. ruminantium major antigenic protein (MAP-1) as the antigen and an anti-MAP-1 monoclonal antibody as the competing indicator reagent. Experimental antisera to C. ruminantium and a wide variety of related ehrlichial organisms were used to evaluate cELISA reactivity. Only sera against C. ruminantium, Ehrlichia canis, E. chaffeensis, and a recently discovered cervine ehrlichia-like organism reacted positively in the cELISA. Specificity of the cELISA was > or = 99.5% in a survey of 1,774 southeastern US and Puerto Rican slaughter cattle sera but was only 85% in a group of 79 hunter-killed white-tailed deer (Odocoileus virginianus) from the southeastern USA. Reference true-positive and cELISA false-positive sera were further analyzed by end point titrations using the cELISA and by indirect fluorescent antibody (IFA) tests for reactivity with C. ruminantium, E. canis, and E. chaffeensis antigens. True heartwater-positive sera were significantly more reactive using the cELISA and C. ruminantium IFA procedures (P < 0.05), whereas false-positive sera were significantly more reactive with the antigens used in the E. chaffeensis IFA procedure (P < 0.05). A group of sera from 210 field-origin ruminants residing on known or potentially heartwater-endemic Caribbean islands revealed a substantial (12.4%) prevalence of cELISA-positive specimens. The cELISA is a relatively specific serodiagnostic test for heartwater in cattle and could be used to monitor for possible introduction of the disease into the USA. The cELISA may also be an excellent tool for monitoring the success of an ongoing Caribbean Amblyomma tick eradication program designed to eliminate the biological vector responsible for the perpetuation and spread of this dangerous foreign animal disease.

Animals↗

PubMed1997

Fingerprinting of Ehrlichia species by repetitive element polymerase chain reaction.

To facilitate identification of ehrlichial pathogens, we developed a new technique based on fingerprints resulting from repetitive element polymerase chain reaction (rep-PCR). This technique uses consensus tRNA primers to generate amplification products that reflect distance polymorphisms between adjacent tRNA genes. Species-specific fingerprint patterns were obtained for seven Ehrlichia spp., as well as the unnamed causative agent of human granulocytotropic ehrlichiosis. Bands ranged in size from approximately 50 to 1,000 base pairs. Banding patterns varied depending on dilution of template DNA, with lower dilutions giving more complex banding patterns. These preliminary data indicate that repetitive-sequence-based PCR appears to be a useful technique for identifying ehrlichial organisms to the species, and perhaps the strain level. Compared with other conventional molecular-biologic methods, rep-PCR offers the advantages of ease of performance and rapid availability of results.

Bacterial Typing Techniques↗

PubMed1997

Development and use of specific polymerase reaction for the detection of an organism resembling Ehrlichia sp. in white-tailed deer.

The role of white-tailed deer (Odocoileus virginianus) in the epidemiology of Ehrlichia chaffeensis and the agent of human granulocytic ehrlichiosis (HGE) is not fully understood, and diagnostic procedures may be complicated by the recent detection of 16S rDNA sequence from an Ehrlichia sp.-like organism in wild deer. A specific forward primer (DGA) and an Ehrlichia spp. reverse primer (GA1UR) were constructed to amplify this new, distinct Ehrlichia sp.-like 16S rDNA. The DGA primer, a forward primer specific for E. chaffeensis (DCH), and a forward primer specific for the E. phagocytophila genogroup (GE9f) were each used with GA1UR in nested polymerase chain reactions to amplify 16S rDNA sequences from control samples containing the deer Ehrlichia sp.-like organism, E. chaffeensis, or the HGE agent. Primer pairs DGA/GA1UR and DCH/GA1UR specifically amplified 16S rDNA sequences from the corresponding target organism, whereas GE9f/GA1UR amplified 16S rDNA sequence from both the HGE agent and the deer Ehrlichia sp.-like organism. With a nested PCR using DGA/GA1UR and DCH/GA1IUR on DNA extracted from white blood cells from 62 deer from 10 populations in four U.S. states, we observed a high prevalence (65%) of 16S rDNA sequences of the deer Ehrlichia sp.-like organism, and a low prevalence (5%) of the E. chaffeensis sequence. In this field survey, E. chaffeensis-reactive antibodies detected by indirect fluorescence assays were associated (P < 0.001) with PCR evidence of the deer Ehrlichia sp.-like organism, but not E. chaffeensis. Infestations of Amblyomma americanum also were associated (P < 0.001) with PCR evidence of the deer Ehrlichia sp.-like organism. The potential for serologic cross-reactions and non-specific PCR products arising from the deer Ehrlichia sp.-like organism should be considered when evaluating the role of deer and their ticks in the epidemiology of ehrlichial pathogens of humans.

Animals↗

PubMed1997

Natural history of Ehrlichia chaffeensis (Rickettsiales: Ehrlichieae) in the piedmont physiographic province of Georgia.

The roles of wild mammals and ticks in the epidemiology of Ehrlichia chaffeensis at a suspected endemic site were investigated using serologic testing, culture, and polymerase chain reaction (PCR) supported by restriction endonuclease analysis and DNA sequencing. Antibodies reactive to E. chaffeensis (> or = 1:64) were detected in 92% of white-tailed deer (Odocoileus virginianus), 21% of raccoons (Procyon lotor), and 8% of opossums (Didelphis virginianus), but not in 8 other species of mammals. Of 7 species of ticks found by host and environmental sampling, Amblyomma americanum was the dominant species, accounting for greater than 99% of all ticks collected. Deer, raccoons, and opossums were the only species parasitized by all life stages of A. americanum, and A. americanum was the only tick parasitizing deer. A nested PCR protocol incorporating E. chaffeensis-specific primers detected E. chaffeensis DNA in blood, lymph nodes, or spleen from 54% of deer examined. The nested PCR detected E. chaffeensis DNA in 6 of 50 (12%) individual adult A. americanum collected from the environment, in 14 of 79 (18%) pools representing 402 adult A. americanum collected from the environment, and in 7 of 25 (28%) pools of mixed stages of A. americanum collected from deer. Although no Ehrlichia spp. were isolated in culture, sequencing of representative amplicons from deer and ticks confirmed PCR products as E. chaffeensis. These data provide strong evidence that white-tailed deer and lone star ticks are the primary reservoir and vector of E. chaffeensis, respectively. The same PCR protocol, incorporating primers specific for an Ehrlichia-like organism of white-tailed deer, detected this organism in blood, lymph nodes, or spleen from 96% of these deer. The Ehrlichia-like organism of deer was detected by PCR from 0 of 50 individual ticks, 7 of 79 (9%) pools, and 1 of 25 (4%) pools of A. americanum collected from deer. Sequencing of representative amplicons from deer and ticks confirmed PCR products as Ehrlichia-like organism of deer. These data suggest that the Ehrlichia-like organism of deer is present in both the deer and lone star ticks populations at this location.

Animals↗

PubMed1996

Perpetuation of the agent of human granulocytic ehrlichiosis in a deer tick-rodent cycle.

A human-derived strain of the agent of human granulocytic ehrlichiosis, a recently described emerging rickettsial disease, has been established by serial blood passage in mouse hosts. Larval deer ticks acquired infection by feeding upon such mice and efficiently transmitted the ehrlichiae after molting to nymphs, thereby demonstrating vector competence. The agent was detected by demonstrating Feulgen-positive inclusions in the salivary glands of the experimentally infected ticks and from field-derived adult deer ticks. White-footed mice from a field site infected laboratory-reared ticks with the agent of human granulocytic ehrlichiosis, suggesting that these rodents serve as reservoirs for ehrlichiae as well as for Lyme disease spirochetes and the piroplasm that causes human babesiosis. About 10% of host-seeking deer ticks were infected with ehrlichiae, and of these, 20% also contained spirochetes. Cotransmission of diverse pathogens by the aggressively human-biting deer tick may have a unique impact on public health in certain endemic sites.

Animals↗

PubMed1996

The interface between research and the diagnosis of an emerging tick-borne disease, human ehrlichiosis due to Ehrlichia chaffeensis.

Two new ehrlichial species that cause human disease have recently been identified: Ehrlichia chaffeensis and the currently unnamed agent of human granulocytic ehrlichiosis. Our objective was to review data on the clinical presentation, laboratory and epidemiological findings, therapy, and diagnostic procedures of patients with human ehrlichiosis due to E chaffeensis. From 1986 through 1994, 400 case patients were identified from 30 US states. Most patients had a nonspecific illness, characterized by fever and headache. Severe illness and death occurred, primarily in the elderly. Laboratory findings most commonly included leukopenia, thrombocytopenia, and elevated liver function test results. Antibody response was the basis for diagnosis, although polymerase chain reaction testing has been useful in research settings. Empirical treatment with tetracycline or its analogues should be begun as soon as possible after the onset of symptoms. Clinicians need to be alert for this illness when evaluating febrile patients whose history includes possible recent tick exposure.

Bacteria↗