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Frontiers in Cellular and Infection... 2020Tularemia is a zoonotic disease caused by the bacterium . The predominant sources, routes of infection, and clinical manifestations of human infections greatly vary... (Review)
Review
Tularemia is a zoonotic disease caused by the bacterium . The predominant sources, routes of infection, and clinical manifestations of human infections greatly vary according to the geographic area considered. Moreover, clinical suspicion of tularemia is often tricky because of the lack of specificity of the clinical manifestations. Because isolation is tedious and detection of its DNA usually requires removal of infected tissues, serological techniques are most often used for diagnostic confirmation. However, these techniques are varied and poorly standardized. The microagglutination test (MAT), the indirect immunofluorescence assay (IFA), and ELISA tests are currently the most frequently used techniques. These home-made and commercial tests are mainly used for tularemia diagnosis but also seroprevalence studies. ELISA tests detect specific antibodies within two weeks of disease evaluation, compared to 2-3 weeks for MAT and IFA. However, more false-positive results are usually reported with ELISA. The long-term persistence of anti- antibodies in patients with past tularemia infection hampers the diagnostic specificity of all these tests. Also, cross-reacting antibodies have been described (especially with and species), although usually at a low level. The immunoblotting technique can highlight these serological cross-reactions. Tularemia remains an underdiagnosed disease in most endemic areas, and the clinical presentations of this disease are evolving. It is necessary to improve further speed and accuracy of tularemia diagnosis, as well as the standardization of diagnostic procedures.
Topics: Adolescent; Adult; Animals; Antibodies, Bacterial; Child; Female; Francisella tularensis; Humans; Male; Middle Aged; Seroepidemiologic Studies; Tularemia; Young Adult; Zoonoses
PubMed: 33194778
DOI: 10.3389/fcimb.2020.512090 -
Clinical Microbiology Reviews Oct 2002Francisella tularensis is the etiological agent of tularemia, a serious and occasionally fatal disease of humans and animals. In humans, ulceroglandular tularemia is the... (Review)
Review
Francisella tularensis is the etiological agent of tularemia, a serious and occasionally fatal disease of humans and animals. In humans, ulceroglandular tularemia is the most common form of the disease and is usually a consequence of a bite from an arthropod vector which has previously fed on an infected animal. The pneumonic form of the disease occurs rarely but is the likely form of the disease should this bacterium be used as a bioterrorism agent. The diagnosis of disease is not straightforward. F. tularensis is difficult to culture, and the handling of this bacterium poses a significant risk of infection to laboratory personnel. Enzyme-linked immunosorbent assay- and PCR-based methods have been used to detect bacteria in clinical samples, but these methods have not been adequately evaluated for the diagnosis of pneumonic tularemia. Little is known about the virulence mechanisms of F. tularensis, though there is a large body of evidence indicating that it is an intracellular pathogen, surviving mainly in macrophages. An unlicensed live attenuated vaccine is available, which does appear to offer protection against ulceroglandular and pneumonic tularemia. Although an improved vaccine against tularemia is highly desirable, attempts to devise such a vaccine have been limited by the inability to construct defined allelic replacement mutants and by the lack of information on the mechanisms of virulence of F. tularensis. In the absence of a licensed vaccine, aminoglycoside antibiotics play a key role in the prevention and treatment of tularemia.
Topics: Animals; Bacterial Vaccines; Disease Models, Animal; Francisella tularensis; Gene Expression Regulation, Bacterial; Humans; Tularemia; Virulence
PubMed: 12364373
DOI: 10.1128/CMR.15.4.631-646.2002 -
Frontiers in Cellular and Infection... 2019, the causative agent of the zoonotic disease tularemia, is characterized by high morbidity and mortality rates in over 190 different mammalian species, including... (Review)
Review
, the causative agent of the zoonotic disease tularemia, is characterized by high morbidity and mortality rates in over 190 different mammalian species, including humans. Based on its low infectious dose, multiple routes of infection, and ability to induce rapid and lethal disease, has been recognized as a severe public health threat-being designated as a NIH Category A Priority Pathogen and a CDC Tier 1 Select Agent. Despite concerns over its use as a bioweapon, most U.S. tularemia cases are tick-mediated and ticks are believed to be the major environmental reservoir for in the U.S. The American dog tick () has been reported to be the primary tick vector for , but the lone star tick () and other tick species also have been shown to harbor . This review highlights what is known, not known, and is debated, about the roles of different tick species as environmental reservoirs and transmission vectors for a variety of genotypes/strains.
Topics: Animals; Dermacentor; Disease Reservoirs; Dog Diseases; Dogs; Francisella tularensis; Genotype; Host-Pathogen Interactions; Humans; Ixodidae; Symbiosis; Tick-Borne Diseases; Ticks; Tularemia; United States
PubMed: 31139576
DOI: 10.3389/fcimb.2019.00146 -
Tidsskrift For Den Norske Laegeforening... Aug 2021The diagnosis of pulmonary tularaemia can be challenging. We present a case illustrating how pulmonary tularaemia may be an important radiological differential diagnosis...
BACKGROUND
The diagnosis of pulmonary tularaemia can be challenging. We present a case illustrating how pulmonary tularaemia may be an important radiological differential diagnosis to lung cancer.
CASE PRESENTATION
A man in his fifties presented with several weeks of dry cough, weight loss and profuse night sweats. The physical examination was normal. A chest computer tomography showed evidence of lymphadenopathy and two consolidated lung masses. The lung masses and lymph nodes showed signs of necrosis. The radiological findings were described as suspicious of lung cancer. A detailed history revealed that he had chopped wood prior to symptom onset. He tested positive for Francisella tularensis IgM and IgG, confirming the diagnosis of pulmonary tularaemia.
INTERPRETATION
The radiological findings in pulmonary tularaemia may mimic lung cancer. Serology is an easy way to confirm the diagnosis, if faced with clinical or radiological suspicion of pulmonary tularaemia.
Topics: Antibodies, Bacterial; Cough; Diagnosis, Differential; Francisella tularensis; Humans; Lung Neoplasms; Male; Tularemia
PubMed: 34423953
DOI: 10.4045/tidsskr.21.0245 -
Journal of the American Veterinary... Mar 2003Tularemia is a rare but potentially fatal disease that develops in numerous wild and domestic animals, including lagomorphs, rodents, cats, and humans. The disease... (Review)
Review
Tularemia is a rare but potentially fatal disease that develops in numerous wild and domestic animals, including lagomorphs, rodents, cats, and humans. The disease occurs throughout much of the United States and should be considered in the differential diagnosis of acute febrile illness, particularly when risk factors such as contact with wild mammals or tick exposure are present. Veterinarians may be at increased risk of acquiring tularemia from contact with infected animals, but standard precautions should greatly reduce this risk. Outbreaks of tularemia warrant investigation, especially given the possibility of the use of F tularensis as an agent of bioterrorism.
Topics: Animals; Animals, Domestic; Animals, Wild; Diagnosis, Differential; Humans; Prognosis; Public Health; Tularemia; United States; Zoonoses
PubMed: 12675294
DOI: 10.2460/javma.2003.222.725 -
Folia Microbiologica Feb 2021Tularemia is a bacterial disease of humans, wild, and domestic animals. Francisella tularensis, which is a Gram-negative coccobacillus-shaped bacterium, is the causative... (Review)
Review
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.
Topics: Animals; Anti-Bacterial Agents; Biological Warfare Agents; Communicable Diseases, Emerging; Disease Transmission, Infectious; Francisella tularensis; Humans; Tick-Borne Diseases; Tularemia
PubMed: 32989563
DOI: 10.1007/s12223-020-00827-z -
Veterinary Research 2005Francisella tularensis is a gram-negative coccobacillus and the etiologic agent of the zoonotic disease tularemia. First described in 1911 in Tulare County, California,... (Review)
Review
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.
Topics: Animals; Communicable Diseases, Emerging; Disease Outbreaks; Francisella tularensis; Global Health; Humans; Tularemia
PubMed: 15845234
DOI: 10.1051/vetres:2005006 -
Virulence Dec 2023Tularaemia is a zoonotic disease caused by the Gram-negative bacterium, . Depending on its entry route into the organism, causes different diseases, ranging from... (Review)
Review
Tularaemia is a zoonotic disease caused by the Gram-negative bacterium, . Depending on its entry route into the organism, causes different diseases, ranging from life-threatening pneumonia to less severe ulceroglandular tularaemia. Various strains with different geographical distributions exhibit different levels of virulence. is an intracellular bacterium that replicates primarily in the cytosol of the phagocytes. The main virulence attribute of is the type 6 secretion system (T6SS) and its effectors that promote escape from the phagosome. In addition, has evolved a peculiar envelope that allows it to escape detection by the immune system. In this review, we cover tularaemia, different strains, and their pathogenicity. We particularly emphasize the intracellular life cycle, associated virulence factors, and metabolic adaptations. Finally, we present how largely escapes immune detection to be one of the most infectious and lethal bacterial pathogens.
Topics: Humans; Francisella tularensis; Virulence; Tularemia; Virulence Factors; Phagosomes
PubMed: 37941380
DOI: 10.1080/21505594.2023.2274638 -
Annals of Agricultural and... Mar 2022Tularaemia is an infrequently occurring disease in Poland. It has therefore rarely been taken into account in the differential diagnosis of skin lesions, lymphadenitis,... (Review)
Review
INTRODUCTION AND OBJECTIVE
Tularaemia is an infrequently occurring disease in Poland. It has therefore rarely been taken into account in the differential diagnosis of skin lesions, lymphadenitis, or soft tissue abscesses. This fact, accompanied by non-specific initial presentation, may lead to a delay in diagnosis and a more severe course of the disease. Objective. The aim of the study is to present the current state of knowledge on tularaemia and convince medical professionals to take it into consideration in the diagnosis of skin lesions, lymphadenitis, and tissue abscesses.
REVIEW METHODS
A literature review using PubMed and other online resources, using terms including 'tularaemia', 'lymphadenitis', etc., was undertaken. Papers were reviewed for relevance and scientific merit.
ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE
Tularaemia, also known as 'rabbit fever', is a zoonotic infection caused by Francisella tularensis, an aerobic, facultative intracellular, gram-negative bacteria. In Europe, it is mainly spread via tick bites and contact with wild animals such as lagomorphs and rodents. Clinical presentation may differ depending on the transmission route; the ulceroglandular and glandular forms of disease predominate. An early diagnosis and implementation of appropriate antibiotic therapy are the cornerstones of successful treatment and make it possible to avoid a surgical incision and drainage of suppurative complications.
SUMMARY
Raised awareness and knowledge on tularaemia among health care professionals are required for timely diagnosis and treatment. Arrival from endemic areas, contact with wild animals, tick bites, and exclusion of more common etiologies of presenting signs should prompt consideration of tularaemia. More research is needed for a better understanding of the burden of the disease and its impact on public health in Poland.
Topics: Animals; Anti-Bacterial Agents; Europe; Francisella tularensis; Rabbits; Tularemia; Zoonoses
PubMed: 35352900
DOI: 10.26444/aaem/139242 -
The European Respiratory Journal Feb 2003Tularaemia is a zoonotic bacterial disease of the Northern hemisphere. The causative agent, Francisella tularensis, is spread to humans by direct contact with infected... (Review)
Review
Tularaemia is a zoonotic bacterial disease of the Northern hemisphere. The causative agent, Francisella tularensis, is spread to humans by direct contact with infected rodents or lagomorphs, aerogenic exposure, ingestion of contaminated food or water, or by arthropod bites. The prevalence of tularaemia shows a wide geographic variation. In some endemic regions, outbreaks occur frequently, whereas nearby rural parts of a country may be completely free. F. tularensis is a facultative intracellular pathogen and its primary mammalian target cell is the mononuclear phagocyte. When tularaemia is acquired via the skin, a primary ulcer is often detected and in general, regional lymph nodes become prominently enlarged. When contracted by inhalation, the disease may present with pneumonia. Nearly as frequent, however, is the development of fever and general illness with no respiratory symptoms and no pulmonary radiological changes. When present, the changes vary widely and may sometimes include hilar enlargement indistinguishable from that of lymphoma. Within an outbreak, the first case of tularaemia is not always readily diagnosed. A decade may have lapsed since the disease was encountered and its existence may be more or less forgotten. The difficulty refers especially to the respiratory form, in which symptoms are less specific. In cases of atypical pneumonia or acute febrile disease with no local symptoms, a history of exposure to hares or rodents or merely living in an endemic region should be sufficient to include tularaemia among differential diagnoses. The microbiological diagnosis of tularaemia relies mainly on serology, and the treatment on broad-spectrum antibiotics. For decades, a live vaccine has been successfully used in risk groups but is presently not available due to difficulties in standardisation.
Topics: Bacterial Vaccines; Francisella tularensis; Humans; Prevalence; Tularemia
PubMed: 12608453
DOI: 10.1183/09031936.03.00088903