Hare-to-Human Transmission of Francisella tularensis subsp. holarctica, Germany

Otto, Peter; Kohlmann, R.; Müller, Wolfgang; Julich, Sandra; Geis, G.; Gatermann, Sören; Peters, Martin C.; Wolf, P.J. van der; Karlsson, Edvin; Forsman, Mats; Myrtennäs, Kerstin; Tomaso, Herbert

doi:10.3201/eid2101.131837

Cited by 20 publications

(15 citation statements)

References 12 publications

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“…Thus F. tularensis was isolated from animal species not previously reported as natural hosts in Germany. In the case of a beaver deceased from tularemia in Brandenburg, it could be confirmed that animals with high bacterial load may act as local amplifiers in Germany (Otto et al, 2015 ; Schulze et al, 2016 ). qPCR analyses indicated that F. tularensis persisted in the aquatic environment during one climatic season, but apparently no longer (Schulze et al, 2016 ).…”

Section: Tularemia In Animalsmentioning

confidence: 98%

Tularemia in Germany—A Re-emerging Zoonosis

Faber

Heuner

Jacob

et al. 2018

Front. Cell. Infect. Microbiol.

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Tularemia, also known as “rabbit fever,” is a zoonosis caused by the facultative intracellular, gram-negative bacterium Francisella tularensis. Infection occurs through contact with infected animals (often hares), arthropod vectors (such as ticks or deer flies), inhalation of contaminated dust or through contaminated food and water. In this review, we would like to provide an overview of the current epidemiological situation in Germany using published studies and case reports, an analysis of recent surveillance data and our own experience from the laboratory diagnostics, and investigation of cases. While in Germany tularemia is a rarely reported disease, there is evidence of recent re-emergence. We also describe some peculiarities that were observed in Germany, such as a broad genetic diversity, and a recently discovered new genus of Francisella and protracted or severe clinical courses of infections with the subspecies holarctica. Because tularemia is a zoonosis, we also touch upon the situation in the animal reservoir and one-health aspects of this disease. Apparently, many pieces of the puzzle need to be found and put into place before the complex interaction between wildlife, the environment and humans are fully understood. Funding for investigations into rare diseases is scarce. Therefore, combining efforts in several countries in the framework of international projects may be necessary to advance further our understanding of this serious but also scientifically interesting disease.

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Section: Tularemia In Animalsmentioning

confidence: 98%

Tularemia in Germany—A Re-emerging Zoonosis

Faber

Heuner

Jacob

et al. 2018

Front. Cell. Infect. Microbiol.

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“…Human infections may have been prevented by local health authorities’ active dissemination of advice to not skin and consume hares, combined with the epizootic starting after closing of the hunting season on 15 January. Current human tularaemia cases in Europe are linked to the skinning of animals, arthropod bites, or contaminated drinking water or dust [ 1 , 3 , 29 ]. Of the six human tularaemia cases identified in the Netherlands between 2011 and 2015, three were linked to skinning of hares and one to insect bites; two cases may have resulted from exposure to an environmental source [ 11 - 13 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Environmental surveillance during an outbreak of tularaemia in hares, the Netherlands, 2015

et al. 2017

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Tularaemia, a disease caused by the bacterium Francisella tularensis, is a re-emerging zoonosis in the Netherlands. After sporadic human and hare cases occurred in the period 2011 to 2014, a cluster of F. tularensis-infected hares was recognised in a region in the north of the Netherlands from February to May 2015. No human cases were identified, including after active case finding. Presence of F. tularensis was investigated in potential reservoirs and transmission routes, including common voles, arthropod vectors and surface waters. F. tularensis was not detected in common voles, mosquito larvae or adults, tabanids or ticks. However, the bacterium was detected in water and sediment samples collected in a limited geographical area where infected hares had also been found. These results demonstrate that water monitoring could provide valuable information regarding F. tularensis spread and persistence, and should be used in addition to disease surveillance in wildlife.

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“…In Deutschland stellt der Kontakt mit erkrankten Hasen den häufigsten Übertragungsweg dar. Die Zahl der Erkrankungen nach Arthropodenstichen ist in den letzten Jahren kontinuierlich angestiegen (10,15,18,20). Zwar konnte F. tularensis nur bei einer geringen Anzahl von Zecken in Nordrhein-Westfalen nachgewiesen werden, von einer zeitlichen und räumlichen Veränderung der Vektoren und Übertragungswege ist aber bei einer steigenden Zahl an Infektionen auch in nicht-endemischen Gebieten wie Deutschland auszugehen (16,22,27).…”

Section: Diskussionunclassified

Die ulzeroglanduläre Tularämie als seltene Ursache unklarer Lymphknotenschwellungen im Kindes- und Jugendalter

Gnatzy¹,

Metzger²,

Schobeß³

et al. 2018

Kinder- und Jugendmedizin

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ZusammenfassungDie ulzeroglanduläre Tularämie ist eine sehr seltene Erkrankung, die sich häufig mit unspezifischen Symptomen wie Fieber, Abgeschlagenheit und einer lokalen Lymphadenopathie manifestiert. Unbehandelt geht sie mit einer Mortalität von 30 % einher. Histopathologisch zeigt sich eine nekrotisierende granulomatösepitheloidzellige Lymphadenitis. Wir berichten über drei Schulkinder aus Mitteldeutschland, die sich sowohl akut krank als auch wenig beeinträchtigt mit einer inguinalen beziehungsweise axillären Lymphadenopathie vorstellten und operativ versorgt werden mussten. Post-operativ bestätigte sich eine akute Infektion mit Francisella tularensis durch Arthropoden. Unter antibiotischer Therapie mit Ciprofloxacin kam es bei allen Patienten zur vollständigen Ausheilung.Anhand der Fallbeispiele werden die klinischen und diagnostischen Herausforderungen der Tularämie im Kindesalter erläutert und ihre oft unterschätzte Rolle in nicht-endemischen Ländern wie Deutschland diskutiert. Bei einer Lymphadenopathie mit protrahiertem Krankheitsverlauf – insbesondere nach Arthropodenstichen – sollte immer an eine Tularämie als seltene Ursache für eine Lymphadenopathie gedacht werden.

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Hare-to-Human Transmission of Francisella tularensis subsp. holarctica, Germany

Cited by 20 publications

References 12 publications

Tularemia in Germany—A Re-emerging Zoonosis

Tularemia in Germany—A Re-emerging Zoonosis

Environmental surveillance during an outbreak of tularaemia in hares, the Netherlands, 2015

Die ulzeroglanduläre Tularämie als seltene Ursache unklarer Lymphknotenschwellungen im Kindes- und Jugendalter

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