Tularemia is a bacterial disease of humans, wild, and domestic animals. Francisella tularensis, which is a Gram-negative coccobacillus-shaped bacterium, is the causative agent of tularemia. Recently, an increase in the number of human tularemia cases has been noticed in several countries around the world. It has been reported mostly from North America, several Scandinavian countries, and certain Asian countries. The disease spreads through vectors such as mosquitoes, horseflies, deer flies, and ticks. Humans can acquire the disease through direct contact of sick animals, consumption of infected animals, drinking or direct contact of contaminated water, and inhalation of bacteria-loaded aerosols. Low infectious dose, aerosol route of infection, and its ability to induce fatal disease make it a potential agent of biological warfare. Tularemia leads to several clinical forms, such as glandular, ulceroglandular, oculoglandular, oropharyngeal, respiratory, and typhoidal forms. The disease is diagnosed through the use of culture, serology, or molecular methods. Quinolones, tetracyclines, or aminoglycosides are frequently used in the treatment of tularemia. No licensed vaccine is available in the prophylaxis of tularemia and this is need of the time and high-priority research area. This review mostly focuses on general features, importance, current status, and preventive measures of this disease.

Department of Microbiology Veterinary Faculty University of Kafkas Kars Turkey

Department of Zoology Government College University Faisalabad Pakistan

Nuclear Institute for Agriculture and Biology Faisalabad Pakistan

Veterinary Control Central Research Institute Bacterial Disease Laboratory Ankara Turkey

Zobrazit více v PubMed

Afanas’ev MV, Mironova LV, Balakhonov SV. MALDI-ToF massspectrometric analysis for the identification of plague, cholera, and tularemia causative agents. MolGenet Microbiol Virol. 2015;30:57–63. doi: 10.3103/S0891416815020020. DOI

Alias T, Fallahzadeh MK, Berhe M. Tularemia presenting as pulmonary nodules in an immunocompromised patient. Proc (Bayl Univ Med Cent) 2017;30:175–176. doi: 10.1080/08998280.2017.11929573. PubMed DOI PMC

American Society for Microbiology (2016) Sentinel level clinical laboratory guidelines for suspected agents of bioterrorism and emerging infectious diseases: Francisella tularensis. https://www.asm.org/images/PSAB/LRN/Tularemia316.pdf

American Veterinary Medical Association (2003) Tularemia facts. https://www.avma.org/tularemia-facts PubMed

Anda P, Segura del Pozo J, Díaz García JM, Escudero R, García Peña FJ, López Velasco MC, Martínez Navarro F. Waterborne outbreak of tularemia associated with crayfish fishing. Emerg Infect Dis. 2001;7:575–582. doi: 10.3201/eid0707.010740. PubMed DOI PMC

Anda P, Pearson A, Tärnvik A (2007) WHO guidelines on tularemia, clinical expression in humans.https://www.who.int/csr/resources/publications/WHO_CDS_EPR_2007_7.pdf?ua=1

Avashia SB, Petersen JM, Lindley CM, Schriefer ME, Gage KL, Cetron M, Kool JL. First reported prairie dog-to-human tularemia transmission, Texas, 2002. Emerg Infect Dis. 2004;10:483–486. doi: 10.3201/eid1003.030695. PubMed DOI PMC

Barbaz M, Piau C, Tadie JM, Pelloux I, Kayal S, Tattevin P, Le Tulzo Y. Rhombencephalitis caused by Francisella tularensis. J Clin Microbiol. 2013;51:3454–3455. doi: 10.1128/JCM.01018-13. PubMed DOI PMC

Barry EM, Cole L, Santiago AE. Vaccines against tularemia. Human Vaccines. 2009;5(12):832–838. doi: 10.4161/hv.10297. PubMed DOI PMC

Belding DL, Merrill B. Tularemia in imported rabbits in Massachusetts. N Engl J Med. 1941;224:1085–1087. doi: 10.1056/NEJM194106262242602. DOI

Bell JF, Stewart SJ. Chronic shedding tularemia nephritis in rodents: possible relation to occurrence of Francisella tularensis in lotic waters. J Wildl Dis. 1975;11:421–430. doi: 10.7589/0090-3558-11.3.421. PubMed DOI

Berdal BP, Mehl R, Meidell NK, Lorentzen-Styr AM, Scheel O. Field investigations of tularemia in Norway. FEMS Immunol Med Microbiol. 1996;13:191–195. doi: 10.1111/j.1574-695X.1996.tb00235.x. PubMed DOI

Blackburn J, Tremblay É, Tsimiklis C, Thivierge B, Lavergne V. Overwhelming sepsis after a cat bite. Can J Infect Dis Med Microbiol. 2013;24:31–32. doi: 10.1155/2013/248397. PubMed DOI PMC

Brett ME, Respicio-Kingry LB, Yendell S, Ratard R, Hand J, Balsamo G, Mead P. Outbreak of Francisella novicida bacteremia among inmates at a Louisiana correctional facility. Clin Infect Dis. 2014;59:826–833. doi: 10.1093/cid/ciu430. PubMed DOI

Büyük F, Çelebi Ö, Çelik E, Çelebi B, Kiliç S, Gülmez Sağlam A, Şahin M. The prevalence of tularemia in occupational groups that have contact with animals. Turkish J Med Sci. 2016;46:451–456. doi: 10.3906/sag-1412-138. PubMed DOI

Byström M, Böcher S, Magnusson A, Prag J, Johansson A. Tularemia in Denmark: identification of a Francisella tularensis subsp. holarctica strain by real-time PCR and high-resolution typing by multiple-locus variable-number tandem repeat analysis. J Clin Microbiol. 2005;43:5355–5358. doi: 10.1128/JCM.43.10.5355-5358.2005. PubMed DOI PMC

Calanan RM, Rolfs RT, Summers J, Coombs J, Amadio J, Holbrook J, Mead P. Tularemia outbreak associated with outdoor exposure along the western side of Utah Lake, Utah, 2007. Public Health Rep. 2010;125:870–876. doi: 10.1177/003335491012500614. PubMed DOI PMC

Carvalho CL, Lopes de Carvalho I, Zé-Zé L, Núncio MS, Duarte EL (2014) Tularaemia: a challenging zoonosis. Comp Immunol Microbiol Infect Dis 37:85–96. 10.1016/j.cimid.2014.01.002 PubMed PMC

Caspar Y, Maurin M. Francisella tularensis susceptibility to antibiotics: a comprehensive review of the data obtained in vitro and in animal models. Front Cell Infect Microbiol. 2017;7(122):1–18. doi: 10.3389/fcimb.2017.00122. PubMed DOI PMC

Centers for Disease Control and Prevention (2018) Tularemia. https://www.cdc.gov/tularemia/statistics/index.html

Christopher GW, Cieslak TJ, Pavlin JA, Eitzen Jr EM (1997) Biological warfare. A historical perspective. J Am Med Assoc 278:412–417 PubMed

Conlan JW. Vaccines against Francisella tularensis - past, present and future. Expert Rev Vaccines. 2004;3:307–314. doi: 10.1586/14760584.3.3.307. PubMed DOI

Decors A, Lesage C, Jourdain E, Giroud P, Houbron P, Vanhem P, Madani N. Outbreak of Tularaemia in brown hares (Lepus europaeus) in France. Euro Surveill. 2011;16:28. PubMed

Dennis DT, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, Tonat K. Tularemia as a biological weapon: medical and public health management. J Am Med Assoc. 2001;285:2763–2773. doi: 10.1001/jama.285.21.2763. PubMed DOI

Dentan C, Pavese P, Pelloux I, Boisset S, Brion J, Stahl J, Maurin M. Treatment of tularemia in pregnant woman, France. Emerg Infect Dis. 2013;19(6):996–998. doi: 10.3201/eid1906.130138. PubMed DOI PMC

Dryselius R, Hjertqvist M, Mäkitalo S, Lindblom A, Lilja T, Eklöf D, Lindström A (2019) Large outbreak of tularaemia, central Sweden, July to September 2019. Euro Surveill 24:1900603. 10.2807/1560-7917.ES.2019.24.42.1900603 PubMed DOI PMC

Efimov VM, Galaktionov Y, Galaktionova TA. Reconstruction and prognosis of water vole population dynamics on the basis of tularemia morbidity among Novosibirsk oblast residents. Dokl Biol Sci. 2003;388:59–61. doi: 10.1023/a:1022456212332. PubMed DOI

Ehrensperger F, Riederer L, Friedl A. Tularemia in a jogger woman after the attack by a common buzzard (Buteo buteo): a "one health" case report. Schweiz Arch Tierheilkd. 2018;160(3):185–188. doi: 10.17236/sat00153. PubMed DOI

Elashvili E, Kracalik I, Burjanadze I, Datukishvili S, Chanturia G, Tsertsvadze N, Beridze L, Shavishvili M, Dzneladze A, Grdzelidze M, Imnadze P, Pearson A, Blackburn JK. Environmental monitoring and surveillance of rodents and vectors for Francisellatularensis following outbreaks of human tularemia in Georgia. Vector Borne Zoonotic Dis. 2015;15:633–636. doi: 10.1089/vbz.2015.1781. PubMed DOI PMC

Eliasson H, Lindback J, Nuorti JP, Arneborn M, Giesecke J, Tegneli A. The 2000 tularemia outbreak: a case control study of risk factors in disease-endemic and emergent areas, Sweden. Emerg Infect Dis. 2002;9:956–960. doi: 10.3201/eid0809.020051. PubMed DOI PMC

Eliasson H, Broman T, Forsman M, Back E. Tularemia: current epidemiology and disease management. Infect Dis Clin N Am. 2006;20:289–311. doi: 10.3201/eid0809.020051. PubMed DOI

Ellis J, Oyston P, Green M, Titball R. Tularemia. Clin Microbiol. 2002;15:631–646. doi: 10.1128/CMR.15.4.631-646.2002. PubMed DOI PMC

Enderlin G, Morales L, Jacobs RF, Cross JT. Streptomycin and alternative agents for the treatment of tularemia: review of the literature. Clin Infect Dis. 1994;19(1):42–47. doi: 10.1093/clinids/19.1.42. PubMed DOI

Erdem H, Ozturk ED, Yesilyurt M, Karabay O, Elaldi N, Celebi G, Agalar C. Evaluation of Tularaemia courses: a multicentre study from Turkey. Clin Microbiol Infect. 2014;20(12):O1042–O1051. doi: 10.1111/1469-0691.12741. PubMed DOI

Esmaeili S, Gooya MM, Shirzadi MR, Esfandiari B, Amiria FB, Behzadi MY, Banafshi O, Mostafavi E. Seroepidemiological survey of tularemia among different groups in western Iran. Int J Infect Dis. 2014;18:27–31. doi: 10.1016/j.ijid.2013.08.013. PubMed DOI

European Centres for Disease Control and Prevention (2019) Tularaemia Annual Epidemiological Report for 2018. https://www.ecdc.europa.eu/en/publications-data/tularaemia-annual-epidemiological-report-2018

Evans ME, Gregory DW, Schaffner W, McGee ZA (1985) Tularemia: a 30-year experience with 88 cases. 64:251–269 PubMed

Forsman M, Sandström G, Sjostedt A. Analysis of 16S ribosomal DNA sequences of Francisella strains and utilization for determination of the phylogeny of the genus and for identification of strains by PCR. Int J Syst Bacteriol. 1994;44:38–46. doi: 10.1099/00207713-44-1-38. PubMed DOI

Friedl A, Heinzer I, Fankhauser H. Tularemia after a dormouse bite in Switzerland. Eur J Clin Microbiol Infect Dis. 2005;24:352–354. doi: 10.1007/s10096-005-1322-x. PubMed DOI

Gaci R, Alauzet C, Selton-Suty C, Lozniewski A, Pulcini C, May T, Goehringer F. Francisella tularensis endocarditis: two case reports and a literature review. Infect Dis (Lond) 2017;49:128–131. doi: 10.1080/23744235.2016.1222546. PubMed DOI

García del Blanco N, Gutiérrez CB, De la Puente VA, Rodríguez Ferri EF. Biochemical characterisation of Francisella tularensis strains isolated in Spain. Vet Rec. 2004;154:55–56. doi: 10.1128/jcm.40.8.2964-2972.2002. PubMed DOI

Geiger JC. Tularemia in cattle and sheep. Calif West Med. 1931;34:1–3. PubMed PMC

GIDEON . Tularemia: global status: Los Angeles. GIDEON Informatics: California; 2018.

GIDEON (2019) Infectious diseases of the world. GIDEON Informatics, Los Angeles, California,GIDEONInformatics.https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-world/

Gliatto JM, Rae JF, McDonough PL, Dasbach JJ. Feline tularemia on Nantucket Island, Massachusetts. J Vet Diagn Investig. 1994;6:102–105. doi: 10.1177/104063879400600120. PubMed DOI

Grunow R, Splettstoesser W, McDonald S, Otterbein C, O’Brien T, Morgan C, Aldrich J, Hofer E, Finke EJ, Meyer H. Detection of Francisella tularensis in biological specimens using a capture enzyme-linked immunosorbent assay, an immunochromatographic handheld assay, and a PCR. Clin Diagn Lab Immunol. 2000;7:86–90. doi: 10.1128/cdli.7.1.86-90.2000. PubMed DOI PMC

Grunow R, Kalaveshi A, Kühn A, Mulliqi-Osmani G, Ramadani N. Surveillance of Tularaemia in Kosovo, 2001 to 2010. Euro Surveill. 2012;17:20217. doi: 10.2807/ese.17.28.20217-en. PubMed DOI

Gürcan Ş. Epidemiology of tularemia. Balkan Med J. 2014;31:3–10. doi: 10.5152/balkanmedj.2014.13117. PubMed DOI PMC

Gurycova D, Kocianova E, Vyrostekova V, Rehacek J. Prevalence of ticks infected with Francisella tularensis in natural foci of tularemia in western Slovakia. Eur J Epidemiol. 1995;11:469–474. doi: 10.1007/BF01721235. PubMed DOI

Gurycová D, Výrosteková V, Khanakah G, Kocianová E, Stanek G (2001) Importance of surveillance of tularemia natural foci in the knownendemic area of Central Europe, 1991-1997. Wien Klin Wochenschr 113:433–438 PubMed

Gyuranecz M, Reiczigel J, Krisztalovics K, Monse L, Szabóné GK, Szilágyi A, Erdélyi K. Factors influencing emergence of tularemia, Hungary 1984-2010. Emerg Infect Dis. 2012;8:1379–1381. doi: 10.3201/eid1808.111826. PubMed DOI PMC

Hansen CM, Vogler AJ, Keim P, Wagner DM, Hueffer K. Tularemia in Alaska, 1938-2010. Acta Vet Scand. 2011;53(61):1–7. PubMed PMC

Haulrig MB, Mathiasen G, Nielsen RM, Kromann CB, Krogfelt KA, Wiese L. Two cases of tick-borne transmitted tularemia on southern Zealand, Denmark. APMIS. 2020;128:61–64. doi: 10.1111/apm.13008. PubMed DOI

Hennebiquea A, Boisset S, Maurin M. Tularemia as a waterborne disease: a review. Emerg Microbes Infect. 2019;8:1027–1042. doi: 10.1080/22221751.2019.1638734. PubMed DOI PMC

Hopla CE. The ecology of tularemia. Adv Vet Sci Comp Med. 1974;18:25–53. PubMed

Hopla CE, Hopla AK, et al. Tularemia. In: Steele JH, et al., editors. CRC handbook of zoonoses. Section a: bacterial, rickettsial and mycotic diseases. 2. Boca Raton, Florida: CRC Press Inc; 1994. pp. 113–125.

Hubálek Z, Halouzka J. Mosquitoes (Diptera: Culicidae), in contrast to ticks (Acari: Ixodidae), do not carry Francisella tularensis in a natural focus of tularemia in the Czech Republic. J Med Entomol. 1997;34:660–663. doi: 10.1093/jmedent/34.6.660. PubMed DOI

Hubalek Z, Treml F, Halouzka J, Juricova Z, Hunady M, Janik V. Frequent isolation of Francisella tularensis from Dermacentor reticulatus ticks in an enzootic focus of tularemia. Med Vet Entomol. 1996;10:241–246. doi: 10.1111/j.1365-2915.1996.tb00737.x. PubMed DOI

Hubalek Z, Sixl W, Halouzka J. Francisella tularensis in Dermacentor reticulatus ticks from the Czech Republic and Austria. Wien Klin Wochenschr. 1998;110:909–910. PubMed

Jackson J, McGregor A, Coole L, Ng J, Brown M, Ong CW, Sintchenko V. Francisella tularensis subspecies holarctica, Tasmania, Australia. Emerg Infect Dis. 2012;18:1484–1486. doi: 10.3201/eid1809.111856. PubMed DOI PMC

Jellison WL, Owen C, Bell JF, Kohls GM. Tularemia and animal populations. Wildl Dis. 1965;17:1–22.

Johansson A, Urich SK, Chu MC, Sjöstedt A, Tärnvik A. In vitro susceptibility to quinolones of Francisella tularensis subspecies tularensis. Scand J Infect Dis. 2002;34:327–330. doi: 10.1080/00365540110080773. PubMed DOI

Johansson A, Farlow J, Larsson P, Dukerich M, Chambers E, Byström M, Fox J, Chu M, Forsman M, Sjöstedt A, Keim P. Worldwide genetic relationships among Francisella tularensis isolates determined by multiple-locus variable-number tandem repeat analysis. J Bacteriol. 2004;186:5808–5818. doi: 10.1128/JB.186.17.5808-5818.2004. PubMed DOI PMC

Johnsrud JJ, Smith CR, Bradsher RW. Serendipitous treatment of tularemia in pregnancy. Open Forum Infect Dis. 2019;6(10):ofz413. doi: 10.1093/ofid/ofz413. PubMed DOI PMC

Karataş Yeni D, İzgür M. Determination of the cross reaction of tularemia titer and Brucella on sheep at specific disease focus in Turkey. Etlik Vet Mikrobiyol Derg. 2015;26:7–10. doi: 10.35864/evmd.513347. DOI

Karataş Yeni D, İzgür M. Investigation on tularemia in potential reservoirs’ of Anatolia. Vet J Ankara Univ. 2015;62:93–98.

Karatuna O, Çelebi B, Can S, Akyar I, Kiliç S. The use of matrix-assisted laser desorption ionization-time of flight mass spectrometry in the identification of Francisellatularensis. Bosn J Basic Med Sci. 2016;16(2):132–138. doi: 10.17305/bjbms.2016.894. PubMed DOI PMC

Karpoff SP, Antonoff NI. The spread of tularemia through water, as a new factor in its epidemiology. J Bacteriol. 1936;32:243–258. doi: 10.1128/JB.32.3.243-258.1936. PubMed DOI PMC

Kaya A, Uysal IO, Guven AS, Engin A, Gulturk A, Icagasioglu FD, Cevit O (2011) Treatment failure of gentamicin in pediatric patients with oropharyngeal tularemia. Med Sci Monit 17:CR376–CR380. https://doi.org/10.12659/MSM.881848 PubMed PMC

Kaysser P, Seibold E, Matz-Rensing K, Pfeffer M, et al. Re-emergence of tularemia in Germany: presence of Francisella tularensis in different rodent species in endemic areas. BMC Infect Dis. 2008;8:157. doi: 10.1186/1471-2334-8-157. PubMed DOI PMC

Keim P, Johansson A, Wagner D. Molecular epidemiology, evolution, and ecology of Francisella. Ann N Y Acad Sci. 2007;1105:30–66. doi: 10.1196/annals.1409.011. PubMed DOI

Kılıç S, Yeşilyurt M. Tularemi: Güncel tedavi seçeneklerine genel bir bakış. Klimik Derg. 2011;24:2–10. doi: 10.5152/kd.2011.02. DOI

Kılıç S, Birdsell DN, Karagöz A, Çelebi B, Bakkaloglu Z, Arikan M, et al. Water as source of Francisella tularensis infection in humans, Turkey. Emerg Infect Dis. 2015;21:2213–2216. doi: 10.3201/eid2112.150634. PubMed DOI PMC

Larson MA, Fey PD, Hinrichs SH, Iwen PC. Francisella tularensis bacteria associated with feline tularemia in the United States. Emerg Infect Dis. 2014;20:2068–2071. doi: 10.3201/eid2012.131101. PubMed DOI PMC

Lindley C, Avashia S, Hendricks K, Rawlings J, et al. Outbreak of tularemia among commercially distributed prairie dogs, 2002. Morb Mortal Wkly Rep. 2002;51:688–699. PubMed

Lopes de Carvalho I, Nascimento P, Núncio MS, Toscano Rico M. First case of tularemia reported in Portugal: probably of imported origin. Front Public Health. 2018;6:325. doi: 10.3389/fpubh.2018.00325. PubMed DOI PMC

Magee JS, Steele RW, Kelly NR, Jacobs RF. Tularemia transmitted by a squirrel bite. Pediatr Infect Dis J. 1989;8:123–125. PubMed

Magnarelli L, Levy S, Koski R. Detection of antibodies to Francisella tularensis in cats. Res Vet Sci. 2007;82:22–26. doi: 10.1016/j.rvsc.2006.06.003. PubMed DOI

Maurin M. Francisella tularensis as a potential agent of bioterrorism? Expert Rev Anti-Infect Ther. 2015;13(2):141–144. doi: 10.1586/14787210.2015.986463. PubMed DOI

Maurin M, Pelloux I, Brion JP, Del Banõ JN, Picard A. Human tularemia in France, 2006-2010. Clin Infect Dis. 2011;53:133–141. doi: 10.1093/cid/cir612. PubMed DOI

Melikjanyan S, Palayan K, Vanyan A, Avetisyan L, Bakunts N, Kotanyan M, Guerra M. Human cases of tularemia in Armenia, 1996-2012. Am J Trop Med Hyg. 2017;97:819–825. doi: 10.4269/ajtmh.16-0605. PubMed DOI PMC

Mohamed Salma ER, Mubarak Aymun I, Alfarooq Lamia O. Francisella tularensis bacteremia: a case report from Sudan. Case Rep Infect Dis. 2012;405737:1–2. doi: 10.1155/2012/405737. PubMed DOI PMC

Moniuszko A, Zajkowska J, Pancewicz S, Kondrusik M, Grygorczuk S, Czupryna P. Arthropod-borne tularemia in Poland: a case report. Vector Borne Zoonotic Dis. 2011;10:1399–1401. doi: 10.1089/vbz.2010.0227. PubMed DOI

Mörner T. The ecology of tularemia. Rev Sci Tech. 1992;11:1123–1130. doi: 10.20506/rst.11.4.657. PubMed DOI

Mörner T, Addison E. Tularemia. Infectious diseases of wild mammals. Iowa: State Press; 2001.

Mörner T, Mattsson R. Tularemia in a rough-legged buzzard (Buteo lagopus) and a Ural owl (Strix uralensis) J Wildl Dis. 1983;19(4):360–361. doi: 10.7589/0090-3558-19.4.360. PubMed DOI

Mörner T, Sandström G, Mattsson R, Nilsson P (1988) Infections with Francisella tularensis biovar palaearctica in hares (Lepus tumidus, Lepus europaeus) from Sweden. J Wildl Dis 24:422–433. 10.7589/0090-3558-24.3.422 PubMed DOI

Müller W, Hotzel H, Otto P, Karger A, Bettin B, Bocklisch H, Braune S, Eskens U, Hörmansdorfer S, Konrad R, Nesseler A, Peters M, Runge M, Schmoock G, Schwarz BA, Sting R, Myrtennäs K, Karlsson E, Forsman M, Tomaso H. German Francisella tularensis isolates from European brown hares (Lepus europaeus) reveal genetic and phenotypic diversity. BMC Microbiol. 2013;13:61. doi: 10.1186/1471-2180-13-61. PubMed DOI PMC

Nakamura K, Fujita H, Miura T, Igata Y, Narita M, Monma N, Hara Y, Saito K, Matsumoto A, Kanemitsu K (2018) A case of typhoidal tularemia in a male Japanese farmer. Int J Infect Dis 71:56–58. 10.1016/j.ijid.2018.03.023 PubMed

Nejeru J, Tomaso H, Mertens K, Henning K, Wareth G, Heller R, Kariuki S, Fevre EM, Neubauer H, Pletz MW. Serological evidence of Francisella tularensis in febrile patients seeking treatment at remote hospitals, northeastern Kenya, 2014-2015. New Microbe and New Infect. 2017;19:62–66. doi: 10.1016/j.nmni.2017.05.015. PubMed DOI PMC

Nordstoga A, Handeland K, Johansen TB, Iversen L, Gavier-Widen D, Mattsson R, et al. Tularaemia in Norwegian dogs. Vet Microbiol. 2014;173:318–322. doi: 10.1016/j.vetmic.2014.06.031. PubMed DOI

Office International des Epizooties (2005) World Animal Health Publication and OIE Handistatus II: Tularemia. http://web.oie.int/hs2/report.asp

Office International des Epizooties (2009) OIE 2005–2009 (Hand status), Manual of standards for diagnostic tests and vaccines: for terrestrial animals (mammals, birds and bees).https://www.oie.int/doc/ged/D7710.PDF PubMed

Ogden NH, Artsob H, Margos G, Tsao J (2014) Non-rickettsial tick-borne bacteria and the diseases they cause, Biology of ticks (2 nd ed.). New York. Oxford University Press

Ohara Y, Sato T, Homma M. Arthropod-borne tularemia in Japan: clinical analysis of 1374 cases observed between 1924-1996. J Med Entomol. 1998;35:471–473. doi: 10.1093/jmedent/35.4.471. PubMed DOI

Ohlin G. Occurrence and mode of transmission of tularaemia in Sweden. Acta Microbiol Scand. 1942;19:220–247. doi: 10.1111/j.1699-0463.1942.tb03345.x. DOI

Olsuf’ev NG, Shlygina KN. Role of cannabalism in the development of tularemia with nonlethal outcome in common voles highly sensitive to tularemia. Zoologicheskii Zhurnal. 1979;58:933–936.

Olsufiev NG. Results and perspectives of the study of natural foci of tularemia in USSR. Med Parazitol (Mosk) 1977;46:273–282. PubMed

Origgi FC, Frey J, Pilo P (2014) Characterisation of a new group of Francisella tularensis subsp. holarctica in Switzerland with altered antimicrobial susceptibilities, 1996 to 2013. Euro Surveill 19 (29): pii: 20858. doi: 10.2807/1560-7917.es2014.19.29.20858 PubMed

Orkun O, Karaer Z, Cakmak A, Nalbantoglu S. Identification of tick-borne pathogens in ticks feeding on humans in Turkey. Plos NTD. 2014;8(8):3067. doi: 10.1371/journal.pntd.0003067. PubMed DOI PMC

O'Toole D, Williams ES, Woods LW, Mills K, Boerger-Fields A, Montgomery DL, Jaeger P, Edwards WH, Christensen D, Marlatt W (2008) Tularemia in range sheep: an overlooked syndrome? J Vet Diagn Invest 20:508–513. 10.1177/104063870802000417 PubMed DOI

Oyston PCF, Quarry E. Tularemia vaccine: past, present and future. Antonie Van Leeuwenhoek. 2005;87:277–281. doi: 10.1007/s10482-004-6251-7. PubMed DOI

Ozkok A, Karadenizli A, Odabas AR. Tularemia in a kidney transplant recipient. Am J Kidney Dis. 2012;60:679. doi: 10.1053/j.ajkd.2012.06.023. PubMed DOI

Padeshki PI, Ivanov IN, Popov B, Kantardjiev TV. The role of birds in dissemination of Francisella tularensis: first direct molecular evidence for bird-to-human transmission. Epidemiol Infect. 2010;138:376–379. doi: 10.1017/S0950268809990513. PubMed DOI

Pavlovsky E. Natural nidality of transmissible diseases. Urbana: IL Univ. Ill. Press; 1966.

Pearson AP (1998) Tularemia. Zoonoses: biology, clinical practice, and public health control. UK, Oxford University Press

Penn RL (1994) Francisella tularensis (Tularemia). In: Wintrobe MM, Thorn GW, Adams RD, Benett IL, BraunwaldE, Isselbacher KJ et al. (Eds). Harrison’s principles of internal medicine. New York: McGraw-Hill pp: 2060–2067

Petrishcheva PA (1965) Vectors of diseases of natural foci. Vol. 54. Israel Program for Scientific Translation, Jerusalem

Pilo P. Phylogenetic lineages of Francisella tularensis in animals. Front Cell Infect Microbiol. 2018;8:258. doi: 10.3389/fcimb. PubMed DOI PMC

Plourde PJ, Embree J, Friesen F, Lindsay G, Williams T. Glandular tularemia with typhoidal features in a Manitoba child. CMAJ. 1992;146:1953–1955. PubMed PMC

Reintjes R, Dedushaj I, Gjini A, Jorgensen TR, Cotter B, Lieftucht A, D’Ancona F, Dennis DT, Kosoy MA, Mulliqi-Osmani G, Grunow R, Kalaveshi A, Gashi L, Humolli I. Tularemia outbreak investigation in Kosovo: case control and environmental studies. Emerg Infect Dis. 2002;8:69–73. doi: 10.3201/eid0801.010131. PubMed DOI PMC

Robert Koch Institute (2017) Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2016. (Article in German). http://www.rki.de/DE/Content/Infekt/Jahrbuch/Jahrbuch_2016.pdf?__blob=publicationFile

Rossow H, Sissonen S, Koskela KA, Kinnunen PM, Hemmila H, Niemimaa J, Huitu O, Kuusi M, Vapalahti O, Henttonen H, Nikkari S. Detection of Francisellatularensis in voles in Finland. Vector Borne Zoonotic Dis. 2014;14:193–198. doi: 10.1089/vbz.2012.1255. PubMed DOI PMC

Rydén P, Björk R, Schäfer ML, Lundström JO, Petersén B, Lindblom A, Forsman M, Anders Sjostedt A, Johansson A (2011) Outbreaks of tularemia in a boreal forest region depends on mosquito prevalence. J Infect Dis 205:297–304. 10.1093/infdis/jir732 PubMed PMC

Sadiku I, Bajrami M, Ramadani H, Mehmeti M, Ponosheci A, Berisha V (2015) Tularemia in children in Kosovo from November 2014–March 2015. 8th International Conference on, Opatija, Croatia, Sept28-Oct1. https://www.tularemianetwork.com/Tularemia/EN/Events/Program_Agenda_Abstract_Book.pdf?__blob=publicationFile

Şahin İ. Tulareminin Genel Epidemiyolojik Özellikleri: Francisella tularensis ve Tularemi. Nobel Tıp Kitabevleri: İstanbul; 2009.

Sandström G, Sjöstedt A, Forsman M, Pavlovich NV, Mishankin BN. Characterization and classification of strains of Francisella tularensis isolated in the central Asian focus of the Soviet Union and in Japan. J Clin Microbiol. 1992;30:172–175. doi: 10.1128/JCM.30.1.172-175.1992. PubMed DOI PMC

Scheftel JM, Griffith JM, Leppke BA, Pantlin GC, et al. Tularaemia in Minnesota: case report and brief epidemiology. Zoonoses Public Health. 2010;57:165–169. doi: 10.1111/j.1863-2378.2009.01318. PubMed DOI

Shoemaker D, Woolf A, Kirkpatrick R, Cooper M. Humoral immune response of cottontail rabbits naturally infected with Francisella tularensis in southern Illinois. J Wildl Dis. 1997;33:733–737. doi: 10.7589/0090-3558-33.4.733. PubMed DOI

Siddaramappa S, Challacombe JF, Petersen JM, Pillai S, Hogg G, Kuske CR. Common ancestry and novel genetic traits of Francisella novicida-like isolates from North America and Australia as revealed by comparative genomic analyses. Appl Environ Microbiol. 2011;77:5110–5122. doi: 10.1128/AEM.00337-11. PubMed DOI PMC

Sinclair JR, Newton A, Hinshaw K, Fraser G, Ross P, Chernak E, Johnson C, Warren N. Tularemia in a park, Philadelphia, Pennsylvania. Emerg Infect Dis. 2008;14:1482–1483. doi: 10.3201/eid1409.071690. PubMed DOI PMC

Sjödin A, Svensson K, Öhrman C, Ahlinder J, Lindgren P, Duodu S, Johansson A, Colquhoun DJ, Larsson P, Forsman M. Genome characterisation of the genus Francisella reveals insight into similar evolutionary paths in pathogens of mammals and fish. BMC Genomics. 2012;13:268. doi: 10.1186/1471-2164-13-268. PubMed DOI PMC

Sjöstedt A. Francisella: Bergey’s manual of systematic bacteriology. 2. New York: Springer; 2005. Family XVII. Francisellaceae, genus I.

Sjöstedt A. Tularemia: history, epidemiology, pathogen physiology and clinical manifestations. Ann N Y Acad Sci. 2007;1105:1–29. doi: 10.1196/annals.1409.009. PubMed DOI

Sjöstedt A (2007b) Epidemiology: WHO guidelines on tularemia. https://www.who.int/csr/resources/publications/WHO_CDS_EPR_2007_7.pdf?ua=1

Sjöstedt A. Clinical manifestations and the epidemiology of tularemia. Med Flum. 2016;52(2):211–216. doi: 10.1196/annals.1409.009. DOI

Staples JE, Kubota KA, Chalcraft LG, Mead PS, Petersen JM. Epidemiologic and molecular analysis of human tularemia, United States, 1964-2004. Emerg Infect Dis. 2006;12:1113–1118. doi: 10.3201/eid1207.051504. PubMed DOI PMC

Syrjala H, Kujala P, Myllyla V, Salminen A. Airborne transmission of tularemia in farmers. Scand J Infect Dis. 1985;17:371–375. doi: 10.3109/13813458509058777. PubMed DOI

Tärnvik A, Chu MC. New approaches to diagnosis and therapy of tularemia. Ann N Y Acad Sci. 2007;1105:378–404. doi: 10.1196/annals.1409.017. PubMed DOI

Taylor JP, Istre GR, McChesney TC, Satalowich FT, et al. Epidemiologic characteristics of human tularemia in the southwest-central states, 1981-1987. Am J Epidemiol. 1991;133:1032–1038. doi: 10.1093/oxfordjournals.aje.a115812. PubMed DOI

Telford SR, Goethert HK. Ecology of Francisella tularensis. Annu Rev Entomol. 2020;65:351–372. doi: 10.1146/annurev-ento-011019-025134. PubMed DOI PMC

Tigertt WD. Soviet viable Pasteurella tularensis vaccines: a review of selected articles. Bacteriol Rev. 1962;26:354–373. doi: 10.1128/BR.26.3.354-373.1962. PubMed DOI PMC

Titball RW, Sjostedt A. Francisella tularensis: an overview. ASM News. 2003;69:558–563.

Uncu M, Süer K, Kocaoğlu M, Şafak MA, Çağlar K. Case report of systemic tularemia in Cyprus. Cyprus J Med Sci. 2017;2:81–84. doi: 10.5152/cjms.2018.301. DOI

Valentino MD, Hensley LL, Skrombolas D, McPherson PL, Woolard MD, Kawula TH, et al. Identification of a dominant CD4 T-cell epitope in the membrane lipoprotein Tul4 from Francisella tularensis LVS. Mol Immunol. 2009;46:1830–1838. doi: 10.1016/j.molimm.2009.01.008. PubMed DOI PMC

Wang Y, Peng Y, Hai R, Xia L, Li H, Zhang Z, Cai H, Liang Y, Shen X, Yu D, Birdsell D, Wagner DM, Keim P. Diversity of Francisella tularensis subsp. holarctica lineages, China. Emerg Infect Dis. 2014;20:1191–1194. doi: 10.3201/eid2007.130931. PubMed DOI PMC

Whipp MJ, Davis JM, Lum G, Boer J, Zhou Y, Bearden SW, Petersen JM, Chu MC, Hogg G. Characterization of a novicida-like subspecies of Francisella tularensis isolated in Australia. J Med Microbiol. 2003;52:839–842. doi: 10.1099/jmm.0.05245-0. PubMed DOI

Wobeser G, Campbell GD, Dallaire A, McBurney S. Tularemia, plague, yersiniosis, and Tyzzer’s disease in wild rodents and lagomorphs in Canada: a review. Can Vet J. 2009;50:1251–1256. PubMed PMC

World Health Organization (WHO) (2007) Guidelines on Tularaemia, Geneva, WHO Press.https://www.who.int/csr/resources/publications/WHO_CDS_EPR_2007_7.pdf?ua=1

Zargar A, Maurin M, Mostafavi E. Tularemia, a re-emerging infectious disease in Iran and neighboring countries. Epidemiol Health. 2015;22(37):e2015011. doi: 10.4178/epih/e2015011. PubMed DOI PMC

Francisella novicida-Containing Vacuole within Dictyostelium discoideum: Isolation and Proteomic Characterization

Francisella and Antibodies