Incidence and prevalence of infection with Anaplasma phagocytophilum. Prospective study in healthy individuals exposed to ticks.

The seroprevalence of human granulocytic anaplasmosis (former human granulocytic ehrlichiosis, HGE) has been documented in several studies, but little data exists on incidence rates in healthy individuals. In a prospective study, we tested 125 healthy adults (mean age 43 years)--workers of the Bialowieza Primeval Forest National Park, north-eastern Poland--for Anaplasma phagocytophilum IgG antibodies using an indirect immunofluorescence antibody assay, and for Borrelia burgdorferi IgG with ELISA in a 12-month interval. The data concerning clinical symptoms consistent with human granulocytic anaplasmosis were collected using a standardized questionnaire. Of these 125 subjects, 9 were anti-A. phagocytophilum positive at the study entry. Four participants (3.2 %) seroconverted from IgG negative to positive during the observation period. Three subjects (2.4 %) converted from initially anti-A. phagocytophilum positive to negative. Specific IgG antibodies against Borrelia burgdorferi were detected in 27 (21.6 %) individuals. Concurrence of Borrelia burgdorferi and Anaplasma phagocytophilum was observed in 3.2 %, whereas 4 % were Anaplasma phagocytophilum IgG positive and Borrelia burgdorferi IgG negative (not significant). Clinical symptoms associated with human granulocytic anaplasmosis were not present in seroconverting individuals. The obtained results confirm the occurrence of Anaplasma phagocytophilum infection in north-eastern Poland with asymptomatic clinical course.