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

Abstract

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.

Clinical Characteristics of Ulceroglandular Tularemia in Two Bulgarian Regions, 2014-2015: a Report of Five Cases

“…24 The clinical manifestation may range from asymptomatic infection to septic shock and death. 25 Signs and symptoms include: a skin ulcer that forms at the site of infection -usually a small lesion, a painful regional lymphadenopathy, fatigue, weight loss, fever, chills, myalgia, joint pain, diarrhea. 4 In our study, medical history and clinical presentation were typical for ulceroglandular form of tularemia.…”

Unique <b><i>Francisella</i></b> Phosphatidylethanolamine Acts as a Potent Anti-Inflammatory Lipid

“…Ftt is readily found in the environment as both a free-living and arthropodtransmitted pathogen [5,6]. Thus, this bacterium also represents a persistent public health threat in both developed and underdeveloped areas of the world [7,8].…”

Environmental Monitoring and Surveillance of Rodents and Vectors for Francisella tularensis Following Outbreaks of Human Tularemia in Georgia

“…The common vole has been implicated in the spillover to other species and in the enzootic maintenance of the bacteria (World Health Organization 2007, Rossow et al 2014, Hestvik et al 2015. A study in Ukraine also identified long-standing foci of F. tularensis associated with the common vole and Dermacentor spp., among other species (Hightower et al 2014).…”

“…Despite recent outbreaks and an increasing incidence in parts of Europe (Hestvik et al 2015), the ecology of F. tularensis is still poorly understood.…”