Clinical-epidemiological characteristics of an ehrlichiosis outbreak at Centro Médico Olanchano in Juticalpa, Olancho 2023

Abstract

Introduction: Ehrlichiosis is a zoonotic disease, caused by Ehrlichia, a pleomorphic obligate intracellular Gram-negative Gram-negative bacterium, transmitted to humans through tick bites. Objective: To determine the clinical-epidemiological characteristics of the outbreak of ehrlichiosis registered in Centro Médico Olanchano de Juticalpa, Honduras, 2023. Methods: Descriptive, retrospective study, 134 patient files were reviewed from patients attending the Internal Medicine outpatient clinic of the Centro Médico Olanchano; 103 met inclusion/exclusion criteria. Diagnosis was made by identification of morulae in peripheral blood smears.Results: Of the patients with ehrlichiosis, 75.7% (78) were female, mean age 58 years. The months with the highest number of Ehrlichia positive cases were April, May and June: 71.8% (74). Clinical manifestations were: fever 35.9% (37), fatigue 27.1% (28) and chills 17.4% (18). One case had a neurological complication of Guillain-Barré syndrome, representing 0.9% (1) at. Only 6.8% (7) recalled being bitten by ticks. 100% received doxycycline; 81.5% (84) had no morulae detected and 18.4% (19) had persistence in the control peripheral blood smear. Discussion: The clinical-epidemiological characteristics of patients with ehrlichiosis showed seasonal behaviour, affecting females, age 58 years. Clinical manifestations were fever, fatigue and chills. Treatment with doxycycline was effective in most cases, and a group of patients required alternative treatment with rifampicin, achieving microbiological eradication.