Abstract
Tularemia outbreaks occurred in northwestern Spain in 1997-1998 and 2007-2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002-00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection.
Highlights
Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons
F. tularensis subsp. tularensis is the most virulent subspecies and can cause life-threatening disease; its distribution seems to be restricted to North America, a single report indicated its presence in Europe [4,5,6,7]
We studied 109 F. tularensis isolates: 37 animal and human F. tularensis subsp. holarctica isolates from the first outbreak in northwestern Spain (1997–1998); 61 animal and human isolates from the second tularemia epidemic in the same area (2007–2008); 10 10 isolates obtained in the Czech Republic; and reference strain F. tularensis subsp. tularensis Schu (CAPM 5600)
Summary
Tularemia outbreaks occurred in northwestern Spain in 1997–1998 and 2007–2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Tularensis is the most virulent subspecies and can cause life-threatening disease; its distribution seems to be restricted to North America, a single report indicated its presence in Europe [4,5,6,7]. Its timing coincided with a population peak of the common vole (Microtus arvalis), and the most frequent clinical forms of the disease were typhoidal and pneumonic (65% of the cases), which is consistent with infection being acquired through inhalation of F. tularensis [11,12,13].
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