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Johan S. Bakken, MD
Duluth Clinic Duluth, Minn

J. Stephen Dumler, MD
University of Maryland Baltimore

JAMA. 1995;273(1):23.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—The letter by Dr Reed and colleagues lends further support to the concept that HGE is transmitted by a tick vector.

While the case report suggests transmission of the bacterium to the patient described through the bite of the I scapularis tick, definitive proof for cause and effect is lacking. The tick was described as engorged (a consequence of the blood meal) at the time of removal. Conceivably, the tick could have taken the blood meal after the patient had already become infected with HGE from a different source, but had not yet developed symptoms of HGE at the time when the tick attached. Thus, detection of identical 16S ribosomal DNA profiles for patient blood and tick extract merely proves that the patient and the tick contained the identical bacterium at the time of sampling.

The tick removed was an adult female Ixodes tick. It is unlikely that . . . [Full Text PDF of this Article]

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