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1.
PLoS Negl Trop Dis ; 18(5): e0012141, 2024 May.
Article in English | MEDLINE | ID: mdl-38728365

ABSTRACT

BACKGROUND: Francisella tularensis, the bacterium that causes tularemia, has been a persistent and widespread pathogen in various regions of the world for centuries. Francisella tularensis can affect humans and various domestic and wild animals. The current study aimed to determine the epidemiological status of tularemia in countries of the WHO Eastern Mediterranean Region (EMRO) through a systematic review and meta-analysis. METHODS: All included studies were identified through a systematic search of online databases, including Scopus, PubMed, Web of Science, and EMBASE, through July 26, 2022, using keywords and suitable combinations. We focused on cross-sectional studies investigating the prevalence of F. tularensis. The weighted pooled prevalence was calculated using a random-effects model. RESULTS: A total of 206 studies were identified, of which 20 were finally included in the analysis. The human seroprevalence of tularemia in WHO-EMRO countries was 6.2% (95% CI, 4.2 9.2). In the subgroup analysis, anti-F. tularensis antibodies were found in 6.92% and 5.5% of the high-risk individuals and Iran, respectively. The pooled prevalence of F. tularensis in environmental samples (water and soil) from the WHO-EMRO countries was 5.8% (9.4% by PCR and 0.5% by culture). In addition, 2.5% (95% CI, 0.2 0.22.7) of ticks in WHO-EMRO countries were positive for F. tularensis. The pooled prevalence of F. tularensis in rodents is 2.0% (1.1% by PCR and 3.7% by serology). In addition, 0.6% of domestic ruminants (0.4% by PCR and 2.4% by serology) were positive for F. tularensis in WHO-EMRO countries. CONCLUSION: According to the results of the present study, tularemia is an endemic but neglected disease in the WHO-EMRO region. However, most studies on tularemia are limited to a few countries in this region. Studies on tularemia in human populations, reservoirs, and vectors have been conducted in all countries in the WHO-EMRO region to obtain more detailed information about the epidemiology of tularemia in these regions.


Subject(s)
Francisella tularensis , Tularemia , Tularemia/epidemiology , Tularemia/microbiology , Humans , Animals , Francisella tularensis/isolation & purification , Mediterranean Region/epidemiology , Prevalence , Seroepidemiologic Studies , World Health Organization , Cross-Sectional Studies , Ticks/microbiology
2.
Sci Rep ; 14(1): 12027, 2024 05 26.
Article in English | MEDLINE | ID: mdl-38797747

ABSTRACT

Increasing Arctic temperatures are facilitating the northward expansion of more southerly hosts, vectors, and pathogens, exposing naïve populations to pathogens not typical at northern latitudes. To understand such rapidly changing host-pathogen dynamics, we need sensitive and robust surveillance tools. Here, we use a novel multiplexed magnetic-capture and droplet digital PCR (ddPCR) tool to assess a sentinel Arctic species, the polar bear (Ursus maritimus; n = 68), for the presence of five zoonotic pathogens (Erysipelothrix rhusiopathiae, Francisella tularensis, Mycobacterium tuberculosis complex, Toxoplasma gondii and Trichinella spp.), and observe associations between pathogen presence and biotic and abiotic predictors. We made two novel detections: the first detection of a Mycobacterium tuberculosis complex member in Arctic wildlife and the first of E. rhusiopathiae in a polar bear. We found a prevalence of 37% for E. rhusiopathiae, 16% for F. tularensis, 29% for Mycobacterium tuberculosis complex, 18% for T. gondii, and 75% for Trichinella spp. We also identify associations with bear age (Trichinella spp.), harvest season (F. tularensis and MTBC), and human settlements (E. rhusiopathiae, F. tularensis, MTBC, and Trichinella spp.). We demonstrate that monitoring a sentinel species, the polar bear, could be a powerful tool in disease surveillance and highlight the need to better characterize pathogen distributions and diversity in the Arctic.


Subject(s)
Ursidae , Zoonoses , Ursidae/microbiology , Ursidae/parasitology , Animals , Arctic Regions , Zoonoses/parasitology , Zoonoses/microbiology , Zoonoses/epidemiology , Canada/epidemiology , Toxoplasma/genetics , Toxoplasma/isolation & purification , Trichinella/isolation & purification , Trichinella/genetics , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/isolation & purification , Francisella tularensis/isolation & purification , Francisella tularensis/genetics , Female , Male
3.
Clin Infect Dis ; 78(5): 1222-1231, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38393822

ABSTRACT

BACKGROUND: Tularemia is an important reemerging disease with a multimodal transmission pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden. METHODS: Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011 and 2021 were collected through review of electronic medical records and participant questionnaires; 415 of 784 accepted participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or polymerase chain reaction). A multivariable logistic regression model was used to investigate variables associated with retreatment. RESULTS: Median age of participants was 54 years (interquartile range [IQR], 41.5-65) and 49.2% were female. Although ulceroglandular tularemia was the predominant form (n = 215, 65.7%), there were several cases of pulmonary tularemia (n = 40; 12.2%). Inflammatory markers were largely nonspecific, with monocytosis frequently observed (n = 36/75; 48%). Tularemia was often misdiagnosed on presentation (n = 158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics and 102 (31.2%) retreated. Persistent lymphadenopathy was infrequent (n = 22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with retreatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR, 3.25-20.75] vs 7 [IQR, 4-11.25] days; adjusted P = .076), and doxycycline-based treatment regimen (vs ciprofloxacin; adjusted P = .084), although this was not significant after correction for multiple comparisons. CONCLUSIONS: We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis, and timely commencement of treatment for an appropriate duration.


Subject(s)
Anti-Bacterial Agents , Doxycycline , Tularemia , Humans , Tularemia/drug therapy , Tularemia/diagnosis , Tularemia/epidemiology , Sweden/epidemiology , Female , Middle Aged , Retrospective Studies , Anti-Bacterial Agents/therapeutic use , Male , Adult , Aged , Treatment Outcome , Doxycycline/therapeutic use , Francisella tularensis/isolation & purification , Ciprofloxacin/therapeutic use , Young Adult
4.
Infection ; 52(3): 1181-1184, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38206513

ABSTRACT

Treatment of tularemia during pregnancy is challenging due to toxicity of standard treatment regimens. Here, we report a 31-year-old woman with glandular tularemia who was successfully treated with intravenous azithromycin. Follow-up examinations over a 6-month period showed a sustained response to treatment. She later gave birth to a healthy child.


Subject(s)
Anti-Bacterial Agents , Azithromycin , Pregnancy Complications, Infectious , Tularemia , Humans , Female , Tularemia/drug therapy , Tularemia/diagnosis , Azithromycin/therapeutic use , Pregnancy , Adult , Anti-Bacterial Agents/therapeutic use , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/microbiology , Austria , Treatment Outcome , Francisella tularensis/drug effects , Francisella tularensis/isolation & purification
5.
PLoS One ; 16(12): e0260987, 2021.
Article in English | MEDLINE | ID: mdl-34882733

ABSTRACT

Using diagnostic data and contemporary sampling efforts, we conducted surveillance for a diversity of pathogens, toxicants, and diseases of muskrats (Ondatra zibethicus). Between 1977 and 2019, 26 diagnostic cases were examined from Kansas and throughout the Southeast and Mid-Atlantic, USA. We identified multiple causes of mortality in muskrats, but trauma (8/26), Tyzzer's disease (5/6), and cysticercosis (5/26) were the most common. We also conducted necropsies, during November 2018-January 2019 Pennsylvania muskrat trapping season, on 380 trapper-harvested muskrat carcasses after the pelt was removed. Tissue samples and exudate were tested for presence of or exposure to a suite of pathogens and contaminants. Gastrointestinal tracts were examined for helminths. Intestinal helminths were present in 39.2% of necropsied muskrats, with Hymenolepis spp. (62%) and echinostome spp. (44%) being the most common Molecular testing identified a low prevalence of infection with Clostridium piliforme in the feces and Sarcocystis spp. in the heart. We detected a low seroprevalence to Toxoplasma gondii (1/380). No muskrats were positive for Francisella tularensis or Babesia spp. Cysticercosis was detected in 20% (5/26) of diagnostic cases and 15% (57/380) of our trapper-harvested muskrats. Toxic concentrations of arsenic, cadmium, lead, or mercury were not detected in tested liver samples. Copper, molybdenum, and zinc concentrations were detected at acceptable levels comparative to previous studies. Parasite intensity and abundance were typical of historic reports; however, younger muskrats had higher intensity of infection than older muskrats which is contradictory to what has been previously reported. A diversity of pathogens and contaminants have been reported from muskrats, but the associated disease impacts are poorly understood. Our data are consistent with historic reports and highlight the wide range of parasites, pathogens and contaminants harbored by muskrats in Pennsylvania. The data collected are a critical component in assessing overall muskrat health and serve as a basis for understanding the impacts of disease on recent muskrat population declines.


Subject(s)
Arvicolinae/growth & development , Gastrointestinal Tract/microbiology , Gastrointestinal Tract/parasitology , Metals, Heavy/toxicity , Population Surveillance/methods , Rodent Diseases/epidemiology , Animals , Arvicolinae/microbiology , Arvicolinae/parasitology , Female , Francisella tularensis/isolation & purification , Gastrointestinal Tract/drug effects , Male , Nematoda/isolation & purification , Nematode Infections/complications , Nematode Infections/parasitology , Pennsylvania/epidemiology , Rodent Diseases/chemically induced , Rodent Diseases/microbiology , Rodent Diseases/parasitology , Trematode Infections/complications , Trematode Infections/microbiology , United States/epidemiology
6.
Comput Math Methods Med ; 2021: 6820864, 2021.
Article in English | MEDLINE | ID: mdl-34961822

ABSTRACT

OBJECTIVE: Tularemia, also known as hare fever, is caused by the bacterium Francisella tularensis (F. tularensis) transmitted through diseased wild animals, blood sucking insects, or contaminated water or food, which is distributed worldwide. The purpose of this study was to investigate F. tularensis infection in animal hosts and vectors from six different natural landscape areas in Gansu Province and to identify the genotypes of the detected F. tularensis. METHODS: Rodents were captured by snap traps, and ticks were collected by dragging a cloth over the vegetation or from domestic animals. After species identification, DNA was isolated from the captured animals and detected by nested PCR assays targeting the F. tularensis fopA gene. The positive samples were further amplified to discriminate the species, and another two short-sequence tandem repeat regions (SSTR) were amplified to identify their genotypes. All positive fragments were sequenced and analyzed by ClustalX (5.0) and DNAClub software. RESULTS: A total of 407 rodents of 12 species were captured, among which six rodent species were positive for F. tularensis, with an overall prevalence of 3.93%. The geographical difference in infection rate was statistically significant. At the SSTR9 locus, there were 7 genotypes among positive rodent samples. A total of 1864 ticks were tested for evidence of tularemia by nested PCR assays, 69 of which were positive, with an average positive rate of 3.70% for F. tularensis in ticks. The positive rates were significantly different among different regions. Seven genotypes were identified at the SSTR9 locus, one of which seemed dominant in positive tick samples. All positive samples had the same genotype at the SSTR16 locus. CONCLUSION: There is natural infection of F. tularensis among animal vectors and hosts in Gansu Province, with diverse genotypes.


Subject(s)
Animals, Wild/microbiology , Francisella tularensis/genetics , Francisella tularensis/isolation & purification , Animals , China/epidemiology , Computational Biology , DNA, Bacterial/genetics , Disease Vectors , Francisella tularensis/classification , Genotype , Host Specificity , Humans , Microsatellite Repeats , Rodentia/microbiology , Ticks/microbiology , Tularemia/epidemiology , Tularemia/transmission , Tularemia/veterinary
7.
J Infect Dev Ctries ; 15(6): 812-817, 2021 06 30.
Article in English | MEDLINE | ID: mdl-34242191

ABSTRACT

INTRODUCTION: Tularemia has reemerged and spread throughout Turkey, and the number of cases has increased. In this study, we report on a waterborne outbreak of tularemia in the spring of 2013 in a region which was previously disease-free, and we investigated the reasons for the outbreak. METHODOLOGY: The index case, a 17-year-old male, was diagnosed with oropharyngeal tularemia. An outbreak investigation was initiated after receiving information from other patients with similar symptoms from the same village along with Balkica, Tavas, and Denizli. An epidemiological and environmental investigation was conducted. Tonsil swab specimens/lymph node aspirates collected from patients, and water samples collected from unchlorinated drinking water sources, were cultured. Additionally, a real-time polymerase chain reaction (RT-PCR) was performed on these samples. Serum samples from patients were analyzed for antibody response. RESULTS: A total of 7 patients were found in this outbreak investigation. The attack rate was found to be 1% among the people of the village and 25% among patients' family members. The drinking-water system was contaminated with F. tularensis during this outbreak. CONCLUSIONS: Lack of appropriate water infrastructure and sanitation was the primary reason for this tularemia outbreak in Turkey. Improving the water source infrastructure and sanitation should be the primary approach to preventing tularemia outbreaks.


Subject(s)
Disease Outbreaks , Francisella tularensis/isolation & purification , Tularemia/epidemiology , Water Microbiology , Water Supply , Adolescent , Adult , Female , Humans , Male , Middle Aged , Tularemia/diagnosis , Tularemia/prevention & control , Turkey/epidemiology , Young Adult
9.
BMC Infect Dis ; 21(1): 310, 2021 Mar 31.
Article in English | MEDLINE | ID: mdl-33789598

ABSTRACT

BACKGROUND: Recent seroepidemiological studies have suggested that tularemia could be an endemic bacterial zoonosis in Iran. METHODS: From January 2016 to June 2018, disease cases characterized by fever, cervical lymphadenopathy and ocular involvement were reported in Youzband Village of Kaleybar County, in the East Azerbaijan Province, northwestern Iran. Diagnostic tests included Francisella tularensis serology (including tube agglutination test and ELISA), PCR, and culture. RESULTS: Among 11 examined case-patients, the tularemia tube agglutination test was positive in ten and borderline in one. PCR detected the F. tularensis ISFtu2 elements and fopA gene in one rodent and a spring water sample from the same geographic area. CONCLUSIONS: Based on the clinical manifestations of the disease suggesting an oropharyngeal form of tularemia, serology results in case patients, and F. tularensis detection in the local fauna and aquatic environment, the water supply of the village was the likely source of the tularemia outbreak. Intervention such as dredging and chlorination of the main water storage tank of the village and training of villagers and health care workers in preventive measures and treatment of the illness helped control the infection.


Subject(s)
Francisella tularensis/isolation & purification , Tularemia/diagnosis , Adolescent , Adult , Aged , Agglutination Tests , Animals , Bacterial Outer Membrane Proteins/genetics , Child , Child, Preschool , DNA, Bacterial/metabolism , Female , Francisella tularensis/genetics , Fresh Water/microbiology , Humans , Iran , Male , Mice , Polymerase Chain Reaction , Tularemia/microbiology
10.
Infect Genet Evol ; 90: 104741, 2021 06.
Article in English | MEDLINE | ID: mdl-33556556

ABSTRACT

In Europe, tularemia is caused by Francisella tularensis subsp. holarctica and is a sporadic disease affecting mainly wildlife animals and humans. Classification of this species relies on canonical single nucleotide polymorphisms (canSNPs). Four main clades have been described for F. tularensis subsp. holarctica: B.4, B.6, B.12 and B.16. Phylogeographic studies have shown that clade B.6 is predominant in Western Europe and B.12 in Eastern and Central Europe. Based on this global phylogeny, we aimed to design a molecular typing assay for all genetic subclades of subclade B.11, which is the predominant subclade in clade B.6. We designed high-resolution melting (HRM) primers for the screening of 109 canSNPs divided in seven orders of discrimination for the molecular epidemiology analysis and tracking of Francisella tularensis subsp. holarctica in Western Europe.


Subject(s)
Epidemiological Monitoring , Francisella tularensis/isolation & purification , Real-Time Polymerase Chain Reaction/methods , Tularemia/epidemiology , Europe/epidemiology , Incidence , Tularemia/microbiology
11.
Folia Microbiol (Praha) ; 66(1): 1-14, 2021 Feb.
Article in English | MEDLINE | ID: mdl-32989563

ABSTRACT

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.


Subject(s)
Communicable Diseases, Emerging/microbiology , Francisella tularensis/pathogenicity , Tularemia/microbiology , Animals , Anti-Bacterial Agents/therapeutic use , Biological Warfare Agents , Communicable Diseases, Emerging/drug therapy , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , Disease Transmission, Infectious/prevention & control , Francisella tularensis/isolation & purification , Humans , Tick-Borne Diseases/drug therapy , Tick-Borne Diseases/epidemiology , Tick-Borne Diseases/microbiology , Tick-Borne Diseases/prevention & control , Tularemia/drug therapy , Tularemia/epidemiology , Tularemia/prevention & control
12.
J Appl Microbiol ; 130(4): 1173-1180, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32970936

ABSTRACT

AIM: Rapid detection of biological agents in biodefense is critical for operational, tactical and strategic levels as well as for medical countermeasures. Yersinia pestis, Francisella tularensis, and Bacillus anthracis are high priority agents of biological warfare or bioterrorism and many response forces use lateral flow assays (LFAs) for their detection. Several companies produce these assays, which offer results in short time and are easy to use. Despite their importance, only few publications on the limits of detection (LOD) for LFAs are available. Most of these studies used inactivated bacteria or risk group-2 strains. As the inactivation process in previous studies might have affected the tests' performances, it was our aim in this study to determine and compare the LOD of several commercially available LFAs using viable risk group-3 strains. METHODS AND RESULTS: Lateral flow assays from four different companies for the detection of following bacteria were evaluated: Y. pestis, F. tularensis and B. anthracis spores. Two independent quantification methods for each target organism were applied, in order to ensure high quantification accuracy. LODs varied greatly between tests and organisms and ranged between 104 for Y. pestis-tests and as high as >109 for one B. anthracis-test. CONCLUSION: This work precisely determined the LODs of LFAs from four commercial suppliers. The herein determined LODs differed from results of previous studies. This illustrates the need for using accurately quantified viable risk group 3-strains for determining such LODs. SIGNIFICANCE AND IMPACT OF THE STUDY: Our work bridges an important knowledge gap with regard to LFA LOD. The LODs determined in this study will facilitate better assessment of LFA-results. They illustrate that a negative LFA result is not suited to exclude the presence of the respective agent in the analyzed sample.


Subject(s)
Bacillus anthracis/isolation & purification , Bacteriological Techniques/methods , Francisella tularensis/isolation & purification , Immunoassay/methods , Yersinia pestis/isolation & purification , Bacterial Infections/diagnosis , Bacterial Infections/microbiology , Humans , Limit of Detection , Microbial Viability , Spores, Bacterial/isolation & purification
13.
J Microbiol Methods ; 177: 106055, 2020 10.
Article in English | MEDLINE | ID: mdl-32918935

ABSTRACT

INTRODUCTION: Currently, Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) is being evaluated for its efficacy as a fast bacterial typing tool due to its great speed compared to other molecular methods. In this study, we evaluated MALDI-TOF as a tool for quick identification and typing of Francisella tularensis. MATERIALS AND METHODS: This study encompassed 86 strains from two different geographical origins (Spain and the Czech Republic), which were previously characterised by Pulsed-Field Gel Electrophoresis (PFGE) and Multiple-Locus Variable Number Tandem Repeat Analysis (MLVA). The direct colony method was used for microbial identification. High-quality spectra of the 86 strains were obtained and their main spectra profiles (MSPs) were created for epidemiological typing using MALDI-TOF. Based on the MSPs, principal components were generated and a dendrogram was constructed. An in-house MALDI-TOF library entry was created for each group of PFGE and MLVA strains based on their high-quality spectra. Two dendrograms were obtained using these entries and the unique peaks in each entry were searched. RESULTS: All strains were correctly identified to the species level. No clear divisions were found in the 86-strain dendrogram; however, Spanish and Czech strains appeared separately in dendrograms created using MLVA and PFGE entries. Entries from our in-house MALDI-TOF library revealed 2-4 biomarker peaks for the detection of the five PFGE groups and 1-12 biomarker peaks for the detection of the seven MLVA groups. Finally, two and one specific biomarkers were found in the Czech and Spanish strains, respectively. CONCLUSION: MALDI-TOF can be used to accurately identify F. tularensis strains in less than 15 min. Moreover, data on geographical origin and PFGE and MLVA groups could be obtained in less than one hour after colony growing.


Subject(s)
Bacterial Typing Techniques/methods , Francisella tularensis/isolation & purification , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Tularemia/microbiology , Bacteriological Techniques/methods , Electrophoresis, Gel, Pulsed-Field/methods , Francisella tularensis/classification , Humans , Tularemia/diagnosis , Tularemia/epidemiology
14.
Sci Rep ; 10(1): 11746, 2020 07 16.
Article in English | MEDLINE | ID: mdl-32678173

ABSTRACT

Category A and B biothreat agents are deemed to be of great concern by the US Centers for Disease Control and Prevention (CDC) and include the bacteria Francisella tularensis, Yersinia pestis, Burkholderia mallei, and Brucella species. Underscored by the impact of the 2020 SARS-CoV-2 outbreak, 2016 Zika pandemic, 2014 Ebola outbreak, 2001 anthrax letter attacks, and 1984 Rajneeshee Salmonella attacks, the threat of future epidemics/pandemics and/or terrorist/criminal use of pathogenic organisms warrants continued exploration and development of both classic and alternative methods of detecting biothreat agents. Volatile organic compounds (VOCs) comprise a large and highly diverse group of carbon-based molecules, generally related by their volatility at ambient temperature. Recently, the diagnostic potential of VOCs has been realized, as correlations between the microbial VOC metabolome and specific bacterial pathogens have been identified. Herein, we describe the use of microbial VOC profiles as fingerprints for the identification of biothreat-relevant microbes, and for differentiating between a kanamycin susceptible and resistant strain. Additionally, we demonstrate microbial VOC profiling using a rapid-throughput VOC metabolomics method we refer to as 'simultaneous multifiber headspace solid-phase microextraction' (simulti-hSPME). Finally, through VOC analysis, we illustrate a rapid non-invasive approach to the diagnosis of BALB/c mice infected with either F. tularensis SCHU S4 or Y. pestis CO92.


Subject(s)
Metabolomics/methods , Tularemia/metabolism , Volatile Organic Compounds/metabolism , Animals , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/metabolism , Coronavirus Infections/virology , Disease Outbreaks , Drug Resistance, Microbial/drug effects , Drug Resistance, Microbial/genetics , Female , Francisella tularensis/drug effects , Francisella tularensis/isolation & purification , Francisella tularensis/metabolism , Kanamycin/pharmacology , Mice , Mice, Inbred BALB C , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/metabolism , Pneumonia, Viral/virology , SARS-CoV-2 , Solid Phase Microextraction , Tularemia/microbiology , Tularemia/pathology , Tularemia/veterinary , Volatile Organic Compounds/analysis , Volatile Organic Compounds/isolation & purification , Yersinia pestis/drug effects , Yersinia pestis/isolation & purification , Yersinia pestis/metabolism
15.
Vector Borne Zoonotic Dis ; 20(8): 630-632, 2020 08.
Article in English | MEDLINE | ID: mdl-32349636

ABSTRACT

Tularemia is a widely spread zoonotic disease in the northern hemisphere, caused by the bacterium Francisella tularensis. In humans, tularemia is an acute febrile illness with incidence peaks in late summer to early autumn of outbreak years, but there is no early warning system in place that can reduce the impact of disease by providing timely risk information. In this study, we revisit previously unpublished data on F. tularensis in water, sediment, soil, and small mammals from 1984 in northern Sweden. In addition, we used human case data from the national surveillance system for tularemia in the same year. In the environmental and small mammal material, bank vole (Myodes glareolus) samples from urine and bladder were the only samples that tested positive for F. tularensis. The prevalence of F. tularensis among trapped bank voles was 13.5%, although all six bank voles that were retrieved from owl nest boxes in early May tested positive. Forty-two human tularemia cases were reported from August to December in 1984. Based on these results, we encourage investigating the potential role of tularemia-infected bank voles retrieved from owl nest boxes in spring as an early warning for outbreaks of tularemia among humans in summer and autumn of the same year.


Subject(s)
Arvicolinae/microbiology , Disease Outbreaks/veterinary , Predatory Behavior , Strigiformes/physiology , Tularemia/veterinary , Animals , Francisella tularensis/isolation & purification , Tularemia/microbiology , Tularemia/urine , Zoonoses
16.
Internist (Berl) ; 61(5): 518-521, 2020 May.
Article in German | MEDLINE | ID: mdl-32270231

ABSTRACT

A 33-year-old woman in a seriously ill state presented with hepatic abscesses. The proof of epitheloid-like reactions by biopsy and further serological analysis led to the final diagnosis of tularemia, which represents a rare disease in Germany. Thereafter targeted antibiotic therapy was successfully initiated. The contribution of simultaneously diagnosed celiac disease to the unusual manifestation of tularemia in the liver, remains uncertain.


Subject(s)
Francisella tularensis/isolation & purification , Liver Abscess/microbiology , Tularemia/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , Biopsy , Celiac Disease/diagnosis , Female , Germany , Humans , Treatment Outcome , Tularemia/drug therapy
17.
Health Secur ; 18(2): 83-95, 2020.
Article in English | MEDLINE | ID: mdl-32324068

ABSTRACT

We conducted a comprehensive, multi-phase laboratory evaluation of the Tularemia BioThreat Alert® (BTA) test, a lateral flow assay (LFA) for the rapid detection of Francisella tularensis. The study, conducted at 2 sites, evaluated the limit of detection (LOD) of this assay using the virulent SchuS4 strain and the avirulent LVS strain of F. tularensis. In 6-phase evaluation (linear dynamic range and reproducibility, inclusivity, near-neighbor, environmental background, white powder, and environmental filter extract), 13 diverse strains of F. tularensis, 8 Francisella near neighbors, 61 environmental background organisms, 26 white powders, and a pooled aerosol extract were tested. In the 937 tests performed, the Tularemia BTA demonstrated an LOD of 107 to 108 cfu/mL, with a sensitivity of 100.00%, specificity of 98.08%, and accuracy of 98.84%. These performance data are important for accurate interpretation of qualitative results arising from screening suspicious white powders in the field.


Subject(s)
Aerosols/analysis , Biological Assay/methods , Francisella tularensis/isolation & purification , Powders/analysis , Bioterrorism , Reproducibility of Results , Sensitivity and Specificity
18.
BMC Microbiol ; 20(1): 66, 2020 03 25.
Article in English | MEDLINE | ID: mdl-32213160

ABSTRACT

BACKGROUND: Francisella tularensis is a fastidious, Gram-negative coccobacillus and is the causative agent of tularemia. To assess viability yet overcome lengthy incubation periods, a culture-based PCR method was used to detect early growth of the lowest possible number of F. tularensis cells. This method utilized a previously developed enhanced F. tularensis growth medium and is based on the change in PCR cycle threshold at the start and end of each incubation. RESULTS: To test method robustness, a virulent Type A1 (Schu4) and B (IN99) strain and the avirulent Live Vaccine Strain (LVS) were incubated with inactivated target cells, humic acid, drinking and well water, and test dust at targeted starting concentrations of 1, 10, and 100 CFU mL- 1 (low, mid, and high, respectively). After 48 h, LVS growth was detected at all targeted concentrations in the presence of 106 inactivated LVS cells; while Schu4 and IN99 growth was detected in the presence of 104 Schu4 or IN99 inactivated cells at the mid and high targets. Early detection of F. tularensis growth was strain and concentration dependent in the presence of fast-growing well water and test dust organisms. In contrast, growth was detected at each targeted concentration by 24 h in humic acid and drinking water for all strains. CONCLUSIONS: Results indicated that the culture-based PCR assay is quick, sensitive, and specific while still utilizing growth as a measure of pathogen viability. This method can circumvent lengthy incubations required for Francisella identification, especially when swift answers are needed during epidemiological investigations, remediation efforts, and decontamination verification.


Subject(s)
Bacteriological Techniques/methods , Culture Media/chemistry , Francisella tularensis/growth & development , Bacterial Vaccines/genetics , Bacterial Vaccines/isolation & purification , Francisella tularensis/genetics , Francisella tularensis/isolation & purification , Humic Substances/microbiology , Microbial Viability , Polymerase Chain Reaction
19.
Comp Immunol Microbiol Infect Dis ; 69: 101419, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31972499

ABSTRACT

BACKGROUND: The etiologic agent of tularemia, Francisella tularensis, is transmitted to humans via ingestion of contaminated water or food, arthropods bite, respiratory aerosols, or direct contact with infected animals body fluids or tissues. In the current study, due to the importance of water in transmitting the disease and the report of the disease in different regions of Iran, surface water of Kurdistan province were evaluated for the presence of F.tularensis. MATERIALS AND METHODS: Sampling was carried out in five-counties of Kurdistan province. Sixty-six specimens of surface water were collected. The detection was carried out by targeting ISFtu2 and fopA genes using TaqMan real-time PCR. Moreover, the samples were both cultured and inoculated into NMRI inbreed mice. Spleens of inoculated mice and bacterial isolates were tested by TaqMan real-time PCR. RESULTS: Despite the lack of isolation of F. tularensis, the results of the molecular testing indicate the presence of bacteria in surface water. Molecular positivity of one sample (1.51%) was confirmed using a real-time PCR for both ISFtu2 and fopA genes. Moreover, 4.54% of the samples were positive for ISFtu2. CONCLUSION: Since the in vitro isolation of bacteria from environmental samples is associated with a very low success rate and depends on various environmental parameters, the use of molecular techniques for monitoring of the bacteria in the contaminated areas is fully recommended.


Subject(s)
Francisella tularensis , Tularemia/epidemiology , Tularemia/microbiology , Water Microbiology , Animals , DNA, Bacterial , Environmental Microbiology , Francisella tularensis/genetics , Francisella tularensis/isolation & purification , Humans , Iran/epidemiology , Mice , Public Health Surveillance , Real-Time Polymerase Chain Reaction
20.
J Infect Public Health ; 13(7): 1003-1005, 2020 Jul.
Article in English | MEDLINE | ID: mdl-31937491

ABSTRACT

Tularemia is a zoonotic infection caused by Francisella tularensis. Tularemia has several clinical form in humans, including ulceroglandular, pneumonic, oropharyngeal, oculoglandular, and systemic (typhoidal). Tularemia may develop granulomatous and suppurative lesions, especially in the affected regional lymph nodes and various organs. Patients with hepatic involvement typically have elevated transaminase levels, hepatomegaly and rarely jaundice. Histologically, there are typically suppurative microabscesses with occasional surrounding macrophages. Rarely, hepatic granuloma can develop due to tularemia. We present a case of an 8 year-old male residing in a rural village in Turkey, who came to our hospital after having intermittent fever for four months and right upper abdominal pain for two months. Liver had a nodular appearance in liver imaging and liver biopsy were consistent with granulomatous hepatitis. The microagglutination test was positive for tularemia in the patient who was investigated for granulomatous hepatitis etiology. Symptoms and signs improved with tularemia treatment. We present a rare case of hepatic involvement of tularemia in a child. Clinicians should be suspicious of and evaluate for typhoidal tularemia in patients who present with prolonged fever and non-specific systemic symptoms, potentially with associated abdominal pain.


Subject(s)
Granuloma/etiology , Hepatitis/etiology , Tularemia/complications , Animals , Anti-Bacterial Agents/therapeutic use , Child , Francisella tularensis/isolation & purification , Granuloma/diagnosis , Granuloma/microbiology , Hepatitis/diagnosis , Hepatitis/microbiology , Humans , Lymph Nodes/pathology , Male , Suppuration/etiology , Treatment Outcome , Tularemia/diagnosis , Tularemia/drug therapy , Turkey , Ultrasonography , Zoonoses/complications , Zoonoses/diagnosis
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