Recently, major media outlets have prominently featured the deaths of multiple critically ill patients after tick bites in Xinyang, Henan Province, and other areas, which has caused widespread concern in the community and particular concern among hematologists. Because the main clinical manifestations of these patients are hyperthermia with leukopenia and thrombocytopenia, and in severe cases, multisite bleeding, multiorgan failure, and disseminated intravascular coagulation (DIC), they are very similar to other diseases in hematology, such as acute leukemia and phagocytic syndromes of various causes. This tick-borne disease is called “Human granulocytic anaplasmosis (HGA)” and is caused by Anaplasma phagocytophilum (once called “human granulocytic anaplasmosis”). “Human granulocytic ehrlichiae”) infesting human peripheral blood neutrophils, caused by fever with leukocytosis, thrombocytopenia and multi-organ functional impairment as the main clinical manifestations, is a zoonotic infectious disease. In September 2005, six cases of unexplained fever from the same family were admitted to the infection department of Xianan District People’s Hospital in Xianning City, Hubei Province, China, where the family lived in a mountainous area with tick activity, and one of the severe cases died, which had a history of tick bite before the onset of the disease, and the remaining five cases died after 3-4 days of close contact with the patient. The onset of the disease 3-4 days after close contact with the patient was confirmed as human granulocytic anaplasmosis by the Chinese Center for Disease Control and Prevention (CDC). on October 30, 2006, a 50-year-old farm woman from Wuhu, Anhui Province, developed hyperthermia 10 days after a tick bite, and due to lack of awareness of the disease, the patient quickly turned severe, with hyperthermia, leukocytosis, thrombocytopenia, abnormal liver and kidney function, and hemorrhage from multiple cavities, and was November 4, and was transferred to the Department of Infection of Yiji Mountain Hospital of Wanan Medical College, where he died 18 hours later. Only a few days later, from November 9 to 17, nine more patients with unexplained hyperthermia were admitted to the same department in the same hospital, five of whom were family members of the first patient to die and four of whom were medical staff who had participated in the resuscitation, with the common denominator that none of them had a history of tick bites, but all of them had been exposed to the patient’s blood and secretions during the resuscitation period of the first patient’s hemorrhage. The diagnosis of human agranulocytic anaplasmosis was subsequently confirmed by serological and molecular biology testing. From April to November 2009, 45 patients with confirmed human agranulocytic anaplasmosis were admitted to the infection unit of the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology in Hubei Province, including 36 cases in Hubei Province and 9 cases in Xinyang, Henan Province, all of whom lived in rural areas and had a tick-hosted area 2 weeks prior to the onset of the disease. All patients had a history of activity in tick-hosted areas, including trees or bushes, grass or field work, or poultry contact, for 2 weeks before the onset of the disease, and 10 patients died of complications of multiple organ failure due to late presentation. However, no nosocomial infections occurred because protection was in place. As early as February 2008, the General Office of the Ministry of Health issued the Technical Guide for Prevention and Control of Human Granulocytic Anaplasmosis (Trial) to the health departments and bureaus of all provinces, autonomous regions and municipalities directly under the Central Government and the Health Bureau of Xinjiang Production and Construction Corps. The technical guide includes four parts: “human granulocytic anaplasmosis diagnosis and treatment program (trial)”, “human granulocytic anaplasmosis epidemiological investigation program (trial)”, “human granulocytic anaplasmosis laboratory testing program (trial)” and “human granulocytic anaplasmosis thematic investigation program (trial)”. Among them, the “Human Granulocytic Anaplasmosis Diagnosis and Treatment Protocol (Trial)” is very practical for the front-line clinical doctors and can be considered as a practical guide for diagnosis and treatment, which also has an important guiding role in carrying out timely and effective diagnosis and treatment of human granulocytic anaplasmosis, reducing critical and fatal cases, and preventing the occurrence of nosocomial infections in various places. Ticks are extremely rare in Shanghai and are not included in the parasite surveillance in Shanghai, but major hospitals in Shanghai receive patients from all over the country and even the world every year, many of whom come from hilly, mountainous or forested areas where ticks are active. Patients may be seen locally for sudden onset of persistent high fever, treated symptomatically for accompanying headache, myalgia, malaise, and gastrointestinal symptoms, and if treatment is ineffective and routine blood tests reveal reduced white blood cells and platelets, patients may be referred to the hematology or infection departments of major hospitals in Shanghai as “fever awaiting investigation” or The patient may be admitted to the hematology or infection departments of major hospitals in Shanghai as “fever pending investigation” or “leukocyte and thrombocytopenia cause pending investigation”. Cases of “high fever with leukocytopenia” are very common in clinical practice, and a large proportion of patients have a history of glucocorticoid use before being transferred to Shanghai, as hormones have an antipyretic effect and are the drug of choice for the treatment of immune thrombocytopenia. However, hormones are relatively contraindicated in patients with human granulocytic anaplasmosis after tick infection, and their use without effective antibiotic protection may convert patients to severe disease. Clinicians should be more alert to anaplasmosis, standardize their practice, and take a careful history of “high fever with leukocytopenia and thrombocytopenia,” especially the epidemiologic history, and look for mulberry-shaped inclusion bodies in the cytoplasm of neutrophils on peripheral blood smears in suspected cases, and promptly send blood specimens for serologic and pathogenic testing. and pathogenetic testing. Suspected cases should be treated promptly with empirical antibiotics, preferably doxycycline, with careful use of hormones and attention to isolation and protection. Although human granulocytic anaplasmosis is a new infectious disease, it is controllable and treatable, and there is no need to panic. According to foreign reports, the morbidity and mortality rate is less than 1%, and the key lies in early diagnosis and timely treatment. It is now clear that anaplasmosis due to ticks can develop throughout the year, with a peak in May to October and an incubation period of 7 to 14 days, and the population is generally susceptible, with all age groups being infected with the disease, with high-risk groups being residents, workers and tourists at the source of the tick epidemic, but medical personnel, chaperones and slaughterhouse staff who come into direct contact with the blood and secretions of critically ill or infected animals can be infected if they do not pay attention to protection The disease can occur. Therefore, it is important to raise public awareness and to seek prompt medical attention once bitten by a tick to avoid turning into a serious illness.