In this issue of JAMA, Zhang and colleagues describe a possible nosocomial outbreak of human granulocytic anaplasmosis (HGA) in China.1 The clinical presentation of the index case, a previously healthy 50-year-old woman who developed a febrile illness with rash and massive bleeding and who died 5 days later, is consistent with many infectious etiologies including viral hemorrhagic fever (VHF) for which she was given ribavirin.2 Laboratory studies in 9 subsequent cases in family members and health care workers who had contact with the patient, however, suggested that her disease was HGA.
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