78 - Tularemia

Abstract

Tularemia is an emerging zoonosis caused by the gram-negative, intra-cellular bacterium Francisella tularensis, a biological threat agent. Tularemia-endemic areas have extended in recent years. Human infections are caused by strains belonging to subsp. holarctica (type B strains) in the entire Northern Hemisphere and now Australia, and subsp. tularensis (type A strains) in North America. The clinical manifestations of tularemia vary in different geographic locations due to the predominant modes of infection (through direct contact with wildlife reservoirs, arthropod bites, or direct contact with contaminated environmental features). Water-borne tularemia may lead to large outbreaks. Because the clinical manifestations of tularemia are myriad, diagnosis and administration of an appropriate antibiotic treatment are often delayed. Complications (especially lymph node suppuration) and life-threatening diseases are thus common. Prophylaxis is mainly based on protection from the main sources of infection (especially from contaminated wildlife animals and arthropod bites); no vaccine is currently commercially available.