The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden

Eliasson, Henrik; Lindbäck, Johan; Nuorti, J. Pekka; Arneborn, Malin; Giesecke, Johan; Tegnell, Anders

doi:10.3201/eid0809.020051

Cited by 142 publications

(141 citation statements)

References 18 publications

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“…Males in general and rural populations were found to be more often occupationally exposed (mentioned 11 times), urban populations to be affected through recreational outdoor activities, like hunting and fishing (mentioned 10 times). Contact with domestic animals has on occasion been implicated as a risk factor in connection with tularemia outbreaks in humans [18,[76][77][78][79]. The few papers or case reports on seropositivity to F. tularensis in domestic animals in European countries (see Table 3) often resulted from investigations of potential risk factors for human outbreaks.…”

Section: Human Disease and Risk Factorsmentioning

confidence: 99%

“…In recent years, tularemia has been found in areas not previously known to be affected; for example, in a hare in Thuringia in Germany 2006 [8] and in humans in Kosovo during 1999-2000 [31]. Re-emergence has occurred in humans in several regions of Turkey after decades during which there had been no outbreaks of the disease [25,96].There have been outbreaks of tularemia in humans in areas where the disease had previously been rare, both in Sweden in 2000 [77] and in Germany in 2004 [41]. In some locations, there was evidence that the peaks of infection coincided in humans and in wild animals (e.g.…”

Section: Surveillance Of Wildlife and Humansmentioning

confidence: 99%

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The status of tularemia in Europe in a one-health context: a review

et al. 2014

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SUMMARYThe bacterium Francisella tularensis causes the vector-borne zoonotic disease tularemia, and may infect a wide range of hosts including invertebrates, mammals and birds. Transmission to humans occurs through contact with infected animals or contaminated environments, or through arthropod vectors. Tularemia has a broad geographical distribution, and there is evidence which suggests local emergence or re-emergence of this disease in Europe. This review was developed to provide an update on the geographical distribution of F. tularensis in humans, wildlife, domestic animals and vector species, to identify potential public health hazards, and to characterize the epidemiology of tularemia in Europe. Information was collated on cases in humans, domestic animals and wildlife, and on reports of detection of the bacterium in arthropod vectors, from 38 European countries for the period 1992-2012. Multiple international databases on human and animal health were consulted, as well as published reports in the literature. Tularemia is a disease of complex epidemiology that is challenging to understand and therefore to control. Many aspects of this disease remain poorly understood. Better understanding is needed of the epidemiological role of animal hosts, potential vectors, mechanisms of maintenance in the different ecosystems, and routes of transmission of the disease.

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Section: Human Disease and Risk Factorsmentioning

confidence: 99%

Section: Surveillance Of Wildlife and Humansmentioning

confidence: 99%

The status of tularemia in Europe in a one-health context: a review

et al. 2014

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“…F. tularensis infection has been evidenced in a staggering number of wildlife species including various lagomorphs, rodents, insectivores, carnivores, ungulates, marsupials, birds, amphibians, fish and invertebrates [8,42,43,50]. Arthropods, including ticks, biting flies, and possibly mosquitoes, serve as vectors and potentially, long-term reservoirs [8,24,42,44,50]. Despite the complexity of the global picture of tularemia, the main components of regional disease cycles are much more narrow, typically involving only one to a few, key mammalian and arthropod species.…”

Section: Epidemiologymentioning

confidence: 99%

Tularemia: emergence/re-emergence

2005

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-Francisella tularensis is a gram-negative coccobacillus and the etiologic agent of the zoonotic disease tularemia. First described in 1911 in Tulare County, California, it has since been reported throughout the Northern Hemisphere, with natural infections reported among an unusually wide range of vertebrates and invertebrates. In recent years, tularemia has emerged in new geographic locations, populations, and settings. This review will serve to highlight mechanisms contributing to the recent emergence of tularemia as well as a repertoire of diagnostic tools useful for detecting and diagnosing disease. tularemia / zoonosis / factors of emergence / Francisella tularensis

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“…It is likely, however, for the prevalence of this disease among cats and other reservoir hosts to be higher than the currently known levels, occasionally resulting in notable outbreaks. The widespread human tularemia outbreak in Sweden in the year 2000 was in part attributed to owning a cat in the household (Eliasson et al 2002).…”

mentioning

confidence: 99%

Environmental, Climatic, and Residential Neighborhood Determinants of Feline Tularemia

Raghavan

Harrington²,

Anderson³

et al. 2013

Vector-Borne and Zoonotic Diseases

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Background: Tularemia, caused by a Gram-negative bacterium Francisella tularensis, is an occasional disease of cats in the midwestern United States and a public health concern due to its zoonotic potential. Different environmental, climatic, and pet-owner's housing and socioeconomic conditions were evaluated as potential risk factors for feline tularemia using Geographic Information Systems (GIS) in a retrospective case-control study. Methods: The study included 46 cases identified as positive for tularemia based upon positive immunohistochemistry, isolation of F. tularensis using bacterial culture, and 4-fold or greater change in serum antibody titer for F. tularensis. Cats with a history of fever, malaise, icterus, and anorexia but no lesions characteristic of tularemia and/or negative immunohistochemistry, no isolation of bacteria in bacterial culture, and less than 4-fold raise in serum antibody titer for F. tularensis were treated as controls (n = 93). Candidate geospatial variables from multiple thematic sources were analyzed for association with case status. Variables from National Land Cover Dataset, Soil Survey Geographic Database, US Census Bureau, and Daymet were extracted surrounding geocoded case-control household locations. Univariable screening of candidate variables followed by stepwise multivariable logistic modeling and odds ratios were used to identify strengths of variable associations and risk factors. Results: Living in a residence located in newly urbanized/suburban areas, residences surrounded by areas dominated by grassland vegetation, and mean vapor pressure conditions recorded during the 8 th week prior to case arrival at the hospital are significant risk factors for feline tularemia. Conclusions: Prevention strategies such as acaricide applications in residential backyards during spring and early summer periods and any behavior modifications suitable for cats that will prevent them from contracting infection from ticks or dead animals are necessary. Mean vapor pressure conditions recorded during the 8

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The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden

Cited by 142 publications

References 18 publications

The status of tularemia in Europe in a one-health context: a review

The status of tularemia in Europe in a one-health context: a review

Tularemia: emergence/re-emergence

Environmental, Climatic, and Residential Neighborhood Determinants of Feline Tularemia

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