Molecular and serologic evidence of tick-borne Ehrlichiae in three species of lemurs from St. Catherines Island, Georgia, USA

Trypanosoma cruzi infection in American black bears (Ursus americanus): A case report in a cub from California and serologic survey for exposure in wild black bears from several states

Trypanosoma cruzi is an important cause of disease and death in humans and dogs, and although wildlife infections are common, less is known about disease manifestations. A 12-week-old male American black bear (Ursus americanus) cub with mild lethargy and anorexia presented to a wildlife rehabilitation center in Lake Tahoe, California. The cub continued to become increasingly weak and showed decreasing interest in play and other activities. The cub was anemic and had increased γ-glutamyltransferase (GGT) liver enzymes. A large number of trypanosomes were noted on a thin blood smear. Trypanosoma cruzi was isolated in culture from a subsequent blood collection. Proliferative bony lesions were noted on radiographs, but this finding was considered unrelated to the T. cruzi infection. The number of parasites observed in thin blood smears dramatically dropped over time, but it remained PCR positive until at least nine months. The cub continued to gain weight and became increasingly active. Serum samples from the cub were positive with three different serologic assays (IFA, ELISA, and ICT). The bear was not treated because of the decreasing parasitemia and the improvement in activity and appetite. Although the bear could not be released due to issues unrelated to T. cruzi, it remains healthy in a captive facility. Sequence analysis of the DHFR-TS and COII-ND1 gene sequences confirmed the bear was infected with DTC TcIV. Following the detection of this clinical case, a serologic survey was conducted to determine the prevalence of T. cruzi exposure of black bears in California, North Carolina, and Pennsylvania. Because no serologic assay has been validated for use in bears, three different assays were used. Marked differences in apparent seroprevalence range from 1% (requiring all three assays to be positive) to ∼20.7% (requiring only one assay to be positive). Black bears are naturally exposed to T. cruzi across the United States. Future studies using PCR testing of tissues or blood would be needed to better understand the prevalence of T. cruzi in wild black bears, lineages most commonly associated with infection, and if T. cruzi represents a health threat to bears.

Survey of ticks and tick-borne pathogens in wild chimpanzee habitat in Western Uganda

BACKGROUND

Ticks and tick-borne pathogens significantly impact both human and animal health and therefore are of major concern to the scientific community. Knowledge of tick-borne pathogens is crucial for prescription of mitigation measures. In Africa, much research on ticks has focused on domestic animals. Little is known about ticks and their pathogens in wild habitats and wild animals like the endangered chimpanzee, our closest relative.

METHODS

In this study, we collected ticks in the forested habitat of a community of 100 chimpanzees living in Kibale National Park, Western Uganda, and assessed how their presence and abundance are influenced by environmental factors. We used non-invasive methods of flagging the vegetation and visual search of ticks both on human team members and in chimpanzee nests. We identified adult and nymph ticks through morphological features. Molecular techniques were used to detect and identify tick-borne piroplasmids and bacterial pathogens.

RESULTS

A total of 470 ticks were collected, which led to the identification of seven tick species: Haemaphysalis parmata (68.77%), Amblyomma tholloni (20.70%), Ixodes rasus sensu lato (7.37%), Rhipicephalus dux (1.40%), Haemaphysalis punctaleachi (0.70%), Ixodes muniensis (0.70%) and Amblyomma paulopunctatum (0.35%). The presence of ticks, irrespective of species, was influenced by temperature and type of vegetation but not by relative humidity. Molecular detection revealed the presence of at least six genera of tick-borne pathogens (Babesia, Theileria, Borrelia, Cryptoplasma, Ehrlichia and Rickettsia). The Afrotopical tick Amblyomma tholloni found in one chimpanzee nest was infected by Rickettsia sp.

CONCLUSIONS

In conclusion, this study presented ticks and tick-borne pathogens in a Ugandan wildlife habitat whose potential effects on animal health remain to be elucidated.

Granulocytic anaplasmosis in captive ring-tailed lemur (Lemur catta) in Poland

Background

Anaplasma are obligate intracellular bacteria and aetiological agents of tick-borne diseases of both veterinary and medical interest. The genus Anaplasma comprises six species: Anaplasma marginale, Anaplasma centrale, Anaplasma ovis, Anaplasma phagocytophilum, Anaplasma bovis and Anaplasma platys. They can infect humans, carnivores, ruminants, rodents, insectivores, birds and reptiles. The aim of this study was to present the first clinical case of granulocytic anaplasmosis in a captive ring-tailed lemur in Poland.

Case presentation

A 4-year-old female lemur presented anorexia, epistaxis and tick infestation. The microscopic examination of a blood smear revealed morulae in neutrophils. Polymerase chain reaction test and sequencing of obtained PCR product confirmed infection by the GU183908 Anaplasma phagocytophilum strain. Therapeutic protocol included doxycycline (2.5 mg/kg p.o., b.i.d.) for 3 weeks and the lemur recovered within 24 h.

Conclusions

This is the first report on granulocytic anaplasmosis in a ring-tailed lemur in Europe, indicating that A. phagocytophilum infection must also be considered in differential diagnosis in this animal species, especially in individuals with thrombocytopenia associated with Ixodes ricinus parasitism.

Role of Zoo-Housed Animals in the Ecology of Ticks and Tick-Borne Pathogens-A Review

Ticks are ubiquitous ectoparasites, feeding on representatives of all classes of terrestrial vertebrates and transmitting numerous pathogens of high human and veterinary medical importance. Exotic animals kept in zoological gardens, ranches, wildlife parks or farms may play an important role in the ecology of ticks and tick-borne pathogens (TBPs), as they may serve as hosts for local tick species. Moreover, they can develop diseases of varying severity after being infected by TBPs, and theoretically, can thus serve as reservoirs, thereby further propagating TBPs in local ecosystems. The definite role of these animals in the tick-host-pathogen network remains poorly investigated. This review provides a summary of the information currently available regarding ticks and TBPs in connection to captive local and exotic wildlife, with an emphasis on zoo-housed species.

Genetic profiling for Anaplasma and Ehrlichia species in ticks collected in the Eastern Cape Province of South Africa

Background

Anaplasma and Ehrlichia are emerging tick-borne pathogens that cause anaplasmosis and ehrlichiosis in humans and other animals worldwide. Infections caused by these pathogens are deadly if left untreated. There has been relatively no systematic survey of these pathogens among ticks in South Africa, thus necessitating this study. The presence of Anaplasma and Ehrlichia species were demonstrated by PCR in ticks collected from domestic ruminants at some selected communities in the Eastern Cape of South Africa. The ticks were identified by morphological characteristics and thereafter processed to extract bacterial DNA, which was analyzed for the presence of genetic materials of Anaplasma and Ehrlichia.

Results

Three genera of ticks comprising five species were identified. The screening yielded 16 positive genetic materials that were phylogenetically related to Ehrlichia sequences obtained from GenBank, while no positive result was obtained for Anaplasma. The obtained Ehrlichia sequences were closely related to E. chaffeensis, E. canis, E. muris and the incompletely described Ehrlichia sp. UFMG-EV and Ehrlichia sp. UFMT.

Conclusion

The findings showed that ticks in the studied areas were infected with Ehrlichia spp. and that the possibility of transmission to humans who might be tick infested is high.

Occurrence of Ehrlichia canis in free-living primates of the genus Callithrix

Bacteria of the genus Ehrlichia are Gram-negative and coccoid-shaped microorganisms that cause ehrlichiosis - a serious infectious disease that often leads to death. These bacteria present a strong zoonotic potential and primates may act as reservoir hosts. This study involved a molecular analysis to detect these microorganisms in blood samples collected from nineteen primates of the genus Callithrix living free in an Atlantic Forest fragment in the municipality of Viçosa, state of Minas Gerais, Brazil. One of the 19 primates was found to be infected with Ehrlichia canis. This finding points to a new wild host of E. canis with a strong potential for transmission to humans because of its increasing contact with people. This is the first report of Ehrlichia spp. in primate of the genus Callithrix.

Southern plains woodrats (Neotoma micropus) from southern Texas are important reservoirs of two genotypes of Trypanosoma cruzi and host of a putative novel Trypanosoma species

Trypanosoma cruzi, the causative agent of Chagas' disease, is an important public health and veterinary pathogen. Although human cases are rare in the United States, infections in wildlife, and in some areas domestic dogs, are common. In 2008 and 2010, we investigated T. cruzi prevalence in possible vertebrate reservoirs in southern Texas, with an emphasis on southern plains woodrats (Neotoma micropus). Infection status was determined using a combination of culture isolation, polymerase chain reaction (PCR), and serologic testing. Based on PCR and/or culture, T. cruzi was detected in 35 of 104 (34%) woodrats, 3 of 4 (75%) striped skunks (Mephitis mephitis), 12 of 20 (60%) raccoons (Procyon lotor), and 5 of 28 (18%) other rodents including a hispid cotton rat (Sigmodon hispidus), rock squirrel (Otospermophilus variegatus), black rat (Rattus rattus), and two house mice (Mus musculus). Additionally, another Trypanosoma species was detected in 41 woodrats, of which 27 were co-infected with T. cruzi. Genetic characterization of T. cruzi revealed that raccoon, rock squirrel, and cotton rat isolates were genotype TcIV, while woodrats and skunks were infected with TcI and TcIV. Based on the Chagas Stat-Pak assay, antibodies were detected in 27 woodrats (26%), 13 raccoons (65%), 4 skunks (100%), and 5 other rodents (18%) (two white-ankled mice [Peromyscus pectoralis laceianus], two house mice, and a rock squirrel). Seroprevalence based on indirect immunofluorescence antibody testing was higher for both woodrats (37%) and raccoons (90%), compared with the Chagas Stat-Pak. This is the first report of T. cruzi in a hispid cotton rat, black rat, rock squirrel, and white-ankled mouse. These data indicate that based on culture and PCR testing, the prevalence of T. cruzi in woodrats is comparable with other common reservoirs (i.e., raccoons and opossums) in the United States. However, unlike raccoons and opossums, which tend to be infected with a particular genotype, southern plains woodrats were infected with TcI and TcIV at near equal frequencies.

Experimental infection of two South American reservoirs with four distinct strains of Trypanosoma cruzi

Trypanosoma cruzi (Tc), the causative agent of Chagas disease, is a diverse species with 2 primary genotypes, TcI and TcII, with TcII further subdivided into 5 subtypes (IIa-e). This study evaluated infection dynamics of 4 genetically and geographically diverse T. cruzi strains in 2 South American reservoirs, degus (Octodon degus) and grey short-tailed opossums (Monodelphis domestica). Based on prior suggestions of a genotype-host association, we hypothesized that degus (placental) would more readily become infected with TcII strains while short-tailed opossums (marsupial) would be a more competent reservoir for a TcI strain. Individuals (n=3) of each species were intraperitoneally inoculated with T. cruzi trypomastigotes of TcIIa [North America (NA)-raccoon (Procyon lotor) origin], TcI [NA-Virginia opossum (Didelphis virginiana)], TcIIb [South America (SA)-human], TcIIe (SA-Triatoma infestans), or both TcI and TcIIa. Parasitaemias in experimentally infected degus peaked earlier (7-14 days post-inoculation (p.i.)) compared with short-tailed opossums (21-84 days p.i.). Additionally, peak parasitaemias were higher in degus; however, the duration of detectable parasitaemias for all strains, except TcIIa, was greater in short-tailed opossums. Infections established in both host species with all genotypes, except for TcIIa, which did not establish a detectable infection in short-tailed opossums. These results indicate that both South American reservoirs support infections with these isolates from North and South America; however, infection dynamics differed with host and parasite strain.

Genetically different isolates of Trypanosoma cruzi elicit different infection dynamics in raccoons (Procyon lotor) and Virginia opossums (Didelphis virginiana)

Trypanosoma cruzi is a genetically and biologically diverse species. In the current study we determined T. cruzi infection dynamics in two common North American reservoirs, Virginia opossums (Didelphis virginiana) and raccoons (Procyon lotor). Based on previous molecular and culture data from naturally-exposed animals, we hypothesised that raccoons would have a longer patent period than opossums, and raccoons would be competent reservoirs for both genotypes T. cruzi I (TcI) and TcIIa, while opossums would only serve as hosts for TcI. Individuals (n=2 or 3) of each species were inoculated with 1x10(6) culture-derived T. cruzi trypomastigotes of TcIIa (North American (NA) - raccoon), TcI (NA - opossum), TcIIb (South American - human), or both TcI and TcIIa. Parasitemias in opossums gradually increased and declined rapidly, whereas parasitemias peaked sooner in raccoons and they maintained relatively high parasitemia for 5weeks. Raccoons became infected with all three T. cruzi strains, while opossums only became infected with TcI and TcIIb. Although opossums were susceptible to TcIIb, infection dynamics were dramatically different compared with TcI. Opossums inoculated with TcIIb seroconverted, but parasitemia duration was short and only detectable by PCR. In addition, raccoons seroconverted sooner (3-7days post inoculation) than opossums (10days post inoculation). These data suggest that infection dynamics of various T. cruzi strains can differ considerably in different wildlife hosts.

Natural history of Ehrlichia chaffeensis: vertebrate hosts and tick vectors from the United States and evidence for endemic transmission in other countries

Ehrlichia chaffeensis, an intracellular gram-negative zoonotic bacterium, is the causative agent of human monocytotropic ehrlichiosis (HME). In humans, the disease can range from a mild, non-specific illness with few to no clinical signs to a moderately severe to fatal disease, especially those with compromised immune systems. E. chaffeensis is maintained in a complex cycle involving white-tailed deer (WTD; Odocoileus virginianus) as a primary reservoir and the lone star tick (LST; Amblyomma americanum) as a primary vector. Numerous other species are naturally exposed to E. chaffeensis and disease has been documented in some domestic animals and wildlife including domestic dogs and ring-tailed lemurs. The organism has been found throughout the natural range of the LST and as the tick continues to expand its range, the geographic range of risk for E. chaffeensis infections will likely continue to expand. Recent data have indicated that E. chaffeensis, or a closely related organism, has been found in many species of ticks and vertebrate hosts in numerous countries.

Evaluation of the Chagas Stat-Pak assay for detection of Trypanosoma cruzi antibodies in wildlife reservoirs

An immunochromatographic assay (Chagas Stat-Pak) was evaluated for the detection of Trypanosoma cruzi antibodies in 4 species of wildlife reservoirs. Antibodies to T. cruzi were detected in raccoons (Procyon lotor) (naturally and experimentally infected) and degus (Octodon degu) (experimentally-infected) using the Chagas Stat-Pak. In naturally exposed wild raccoons, the Chagas Stat-Pak had a sensitivity and specificity of 66.7-80.0% and 96.3%, respectively. Compared with indirect immunofluorescent antibody assay results, seroconversion as determined by Chagas Stat-Pak was delayed for experimentally infected raccoons, but occurred sooner in experimentally infected degus. The Chagas Stat-Pak did not detect antibodies in naturally or experimentally infected Virginia opossums (Didelphis virginiana) or in experimentally infected short-tailed opossums (Monodelphis domestica). These data suggest that the Chagas Stat-Pak might be useful in field studies of raccoons and degus when samples would not be available for more-conventional serologic assays. Because this assay did not work on either species of marsupial, the applicability of the assay should be examined before it is used in other wild species.

Oral transmission of Trypanosoma cruzi with opposing evidence for the theory of carnivory

We present the first demonstration of oral transmission of Trypanosoma cruzi to raccoons (Procyon lotor), a natural reservoir host in the United States, by ingestion of trypomastigotes and infected bugs, but not infected tissue. To investigate an alternative, non-vector-based transmission method, we tested the hypothesis that raccoons scavenging on infected hosts results in patent infection. Macerated tissue from selected organs infected with amastigote stages of T. cruzi was orally administered to experimental groups of raccoons (n = 2/group) at 2, 12, or 24 hr after collection of the tissue samples. Additionally, raccoons (n=1) in control groups were inoculated intravenously or per os with trypomastigotes. To further elucidate transmission routes of T. cruzi to raccoons, infected Rhodnius prolixus were fed to raccoons (n=2). Raccoons did not become infected after ingestion of amastigote-infected tissues as evidenced by negative polymerase chain reaction results from blood and tissue, lack of seroconversion, and negative parasitemias. However, per os transmission can occur by ingestion of the infective trypomastigote stage or infected reduviid bugs. We conclude from these findings that oral transmission of T. cruzi may be a route of infection for wildlife in sylvatic cycles, but the scavenging behavior of animals is not likely a significant transmission route.

Host surveys, ixodid tick biology and transmission scenarios as related to the tick-borne pathogen, Ehrlichia canis

The ehrlichioses have been subject to increasing interest from veterinary and public health perspectives, but experimental studies of these diseases and their etiologic agents can be challenging. Ehrlichia canis, the primary etiologic agent of canine monocytic ehrlichiosis, is relatively well characterized and offers unique advantages and opportunities to study interactions between a monocytotropic pathogen and both its vertebrate and invertebrate hosts. Historically, advances in tick-borne disease control strategies have typically followed explication of tick-pathogen-vertebrate interactions, thus it is reasonable to expect novel, more sustainable approaches to control of these diseases as the transmission of their associated infections are investigated at the molecular through ecological levels. Better understanding of the interactions between E. canis and its canine and tick hosts would also elucidate similar interactions for other Ehrlichia species as well as the potential roles of canine sentinels, reservoirs and models of tick-borne zoonoses. This article summarizes natural exposure studies and experimental investigations of E. canis in the context of what is understood about biological vectors of tick-borne Anaplasmataceae.

Role of the lone star tick, Amblyomma americanum (L.), in human and animal diseases

We reviewed scientific literature pertaining to known and putative disease agents associated with the lone star tick, Amblyomma americanum. Reports in the literature concerning the role of the lone star tick in the transmission of pathogens of human and animal diseases have sometimes been unclear and even contradictory. This overview has indicated that A. americanum is involved in the ecology of several disease agents of humans and other animals, and the role of this tick as a vector of these diseases ranges from incidental to significant. Probably the clearest relationship is that of Ehrlichia chaffeensis and A. americanum. Also, there is a definite association between A. americanum and tularemia, as well as between the lone star tick and Theileria cervi to white-tailed deer. Evidence of Babesia cervi (= odocoilei) being transmitted to deer by A. americanum is largely circumstantial at this time. The role of A. americanum in cases of southern tick-associated rash illness (STARI) is currently a subject of intensive investigations with important implications. The lone star tick has been historically reported to be a vector of Rocky Mountain spotted fever rickettsiae, but current opinions are to the contrary. Evidence incriminated A. americanum as the vector of Bullis fever in the 1940s, but the disease apparently has disappeared. Q fever virus has been found in unfed A. americanum, but the vector potential, if any, is poorly understood at this time. Typhus fever and toxoplasmosis have been studied in the lone star tick, and several non-pathogenic organisms have been recovered. Implications of these tick-disease relationships are discussed.

Molecular typing of Trypanosoma cruzi isolates, United States

Studies have characterized Trypanosoma cruzi from parasite-endemic regions. With new human cases, increasing numbers of veterinary cases, and influx of potentially infected immigrants, understanding the ecology of this organism in the United States is imperative. We used a classic typing scheme to determine the lineage of 107 isolates from various hosts.

Trypanosoma cruzi prevalence and epidemiologic trends in lemurs on St. Catherines Island, Georgia

Lemurs on St. Catherines Island, Georgia were tested for Trypanosoma cruzi infection to develop a better understanding of the epizootiology of the parasite in nonhuman primates in the southeastern United States. Fifty-six ring-tailed (Lemur catta), blue-eyed black (Eulemur macaco flavifrons), and black-and-white ruffed (Varecia variegata variegata) lemurs were tested by hemoculture and serology to determine the prevalence of T. cruzi in the population. Of those tested 3 (5%) were identified as culture positive and 25 (44.6%) as seropositive. When hemoculture results were compared with those from a similar study performed in 1997, prevalence remained unchanged. Genetic characterization of the 3 culture isolates indicated they belong to the T. cruzi IIa group, which is identical to strains previously isolated from raccoons on the island. Despite the occurrence of T. cruzi in the population, there was no evidence that the health of the lemurs was compromised as a result of infection. Based upon prevalence and available breeding records we speculate that both vertical and vector-mediated transmission play significant roles in the epidemiology of T. cruzi on the island. This also represents the first report of autochthonous infection in blue-eyed black and black-and-white ruffed lemurs.

Autochthonous transmission of Trypanosoma cruzi, Louisiana

Autochthonous transmission of the Chagas disease parasite, Trypanosoma cruzi, was detected in a patient in rural New Orleans, Louisiana. The patient had positive test results from 2 serologic tests and hemoculture. Fifty-six percent of 18 Triatoma sanguisuga collected from the house of the patient were positive for T. cruzi by PCR.

Seroprevalence of Toxoplasma gondii, Sarcocystis neurona, and Encephalitozoon cuniculi in three species of lemurs from St. Catherines Island, GA, USA

In the current study, we determined the seroprevalence of Toxoplasma gondii, Sarcocystis neurona, and Encephalitozoon cuniculi in three species of lemurs from St. Catherines Island, Georgia. Serum samples were tested from 52 ring-tailed lemurs (Lemur catta), six blue-eyed black lemurs (Eulemur macaco flavifrons), and four black and white ruffed lemurs (Varecia variegata variegata) using an agglutination assay. Three ring-tailed lemurs (5.8%) were positive for T. gondii (titer of 1:50); one ring-tailed lemur (1.9%) and one black and white ruffed lemur (25%) were positive for S. neurona (titers of 1:1000); and one ring-tailed lemur (1.9%) was positive for E. cuniculi (titer of 1:400). All blue-eyed black lemurs were negative for antibodies to T. gondii, S. neurona, and E. cuniculi. This is the first detection of antibodies to T. gondii in ring-tailed lemurs and antibodies to S. neurona and E. cuniculi in any species of prosimian.

Ecological havoc, the rise of white-tailed deer, and the emergence of Amblyomma americanum-associated zoonoses in the United States

Two infectious diseases, and one presumably infectious disease, each vectored by or associated with the bite of the lone star tick (Amblyomma americanum), were identified and characterized by clinicians and scientists in the United States during the 1980s and 1990s. These three conditions-human monocytic (or monocytotropic) ehrlichiosis (HME), Ehrlichia ewingii ehrlichiosis, and southern tick-associated rash illness (STARI)-undoubtedly existed in the United States prior to this time. However, the near-simultaneous recognition of these diseases is remarkable and suggests the involvement of a unifying process that thrust multiple pathogens into the sphere of human recognition. Previous works by other investigators have emphasized the pivotal role of white-tailed deer (Odocoileus virginianus) in the emergence of Lyme disease, human babesiosis, and human granulocytic anaplasmosis. Because whitetails serve as a keystone host for all stages of lone star ticks, and an important reservoir host for Ehrlichia chaffeensis, E. ewingii, and Borrelia lonestari, the near-exponential growth of white-tailed deer populations that occurred in the eastern United States during the twentieth century is likely to have dramatically affected the frequency and distribution of A. americanum-associated zoonoses. This chapter describes the natural histories of the pathogens definitively or putatively associated with HME, E. ewingii ehrlichiosis, and STARI; the role of white-tailed deer as hosts to lone star ticks and the agents of these diseases; and the cascade of ecologic disturbances to the landscape of the United States that have occurred during the last 200 years that provided critical leverage in the proliferation of white-tailed deer, and ultimately resulted in the emergence of these diseases in human populations.

Co-infection of White-Tailed Deer with Multiple Strains ofEhrlichia chaffeensis

We investigated the effect of exposing deer to multiple strains of Ehrlichia chaffeensis that differed in number of tandem repeats in either the variable-length PCR target (VLPT) gene or 120 kDa antigen gene. We hypothesized that infection with one strain would provide immunity to infection with other strains of E. chaffeensis. All deer initially exposed to strain A (604-2) became PCR and culture positive by 10 days post-infection (DPI). Three deer infected with strain A and subsequently inoculated with strain B (623-4) became infected with strain B. Two deer infected with strain A and subsequently inoculated with strain C (125B) became infected with strain C. Of three deer, each infected with strain B and subsequently inoculated with strain C, one was PCR positive for strain C. Of three deer previously inoculated with both strains A and B, and subsequently inoculated with strain C, one showed delayed evidence of strain C. Western blot analysis demonstrated that deer sera reacted differently to antigens from each exposed strain. A complementary in vitro study demonstrated that exposure to two strains differing in VLPT repeats may lead to co-infection of DH82 cells. These results complement a previous study and further show that deer can become sequentially infected with up to three strains of E. chaffeensis. This suggests that competitive exclusion, a phenomenon described in related organisms such as Anaplasma marginale whereby infection with one strain precludes subsequent infection by a second, distinct strain of the same species, may not occur with E. chaffeensis.

Primary and Secondary Infection withEhrlichia chaffeensisin White-Tailed Deer (Odocoileus virginianus)

White-tailed deer (Odocoileus virginianus) are the principal reservoir host for Ehrlichia chaffeensis, causative agent of human monocytic ehrlichiosis (HME). Because white-tailed deer maintain a long-term infection with E. chaffeensis and because deer can be naturally exposed to multiple strains of E. chaffeensis, we evaluated the response to secondary infection of E. chaffeensis in deer. For primary infection, six white-tailed deer were injected with 5.4 x 10(6) DH82 cells infected with the Arkansas strain of E. chaffeensis (Ark) and two control deer were injected with noninfected DH82 cells. On post-infection day 54, three E. chaffeensis (Ark) infected deer and one naive deer were injected with 4.2 x 10(6) cells infected with strain WTD-6045B E. chaffeensis, which differs from the Arkansas strain by number of nucleotide repeats in the variable length PCR target (VLPT) gene; three other Arkansas strain infected deer were injected with noninfected DH82 cells. All animals were monitored for 31 additional days. All deer in the primary infection became positive by PCR amplification of the 16S rRNA or VLPT genes and/or cell culture by DPI-8. PCR amplification of the VLPT gene on whole blood, cell culture, and tissues detected primary and/or secondary strains in all deer exposed to both primary and secondary strains; in one deer, the primary strain was cultured from the lymph node. Our culture results demonstrated that both strains were present; however, PCR detection suggests that the secondary strain may have been circulating in blood at higher levels. In conclusion, this study provides evidence that primary infection of deer with E. chaffeensis does not protect against subsequent exposure and confirms that deer can be simultaneously coinfected with at least two different strains of E. chaffeensis.