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Dual infection with Ehrlichia chaffeensis and a spotted fever group rickettsia: a case report.

Centers for Disease Control
Publication Date
  • Letter
  • Medicine


705Vol. 4, No. 4, October December 1998 Emerging Infectious Diseases Letters Among the 54 reporting systems for which further information was obtained, clinical diagnoses (in some countries laboratory con- firmed) are reported through the hierarchical chain, normally by mail or facsimile, but in two countries by electronic links. Almost all military reporting systems are parallel to civilian systems. Thirty-four (63%) of 54 systems feed into the civilian system, with a built-in mechanism to avoid duplicate reporting; 16 (30%) systems feeding into the civilian system have no such mechanism in place; and four have no link with the civilian system. The third survey addressed vaccination policies. Among 52 countries that replied, 47 (90%) have a compulsory military vaccination schedule: 45 (87%) for tetanus, 30 (58%) for diphtheria, 23 (44%) for typhoid, 16 (31%) for bacillus Calmette-GuØrin and polio, 12 (23%) for meningococcal meningitis, and 10 (19%) for measles, mumps, and rubella. These surveys show that military popula- tions are protected against many infectious diseases and that a wealth of information is obtained by military laboratories and health- care facilities on populations at high risk for infectious diseases. While most of the informa- tion collected from the health-care facilities is reported through civilian systems as well, incorporating the military network of laborato- ries into the WHO global surveillance network could ensure broader coverage. Raffaele D Amelio* and David L. Heymann *Ministero della Difesa, Direzione Generale Sanità Militare, Roma, Italy; and World Health Organization, Geneva, Switzerland Reference 1. Heymann DL, Rodier GG. Global surveillance of Communicable Diseases. Emerg Infect Dis 1998;4:362-5. Dual Infection with Ehrlichia chaffeensis and a Spotted Fever Group Rickettsia: A Case Report To the Editor: In their article, Daniel J. Sexton et al. state, Well- documented cases of simulta- neous human infections with more than one tick

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