Tularemia: a propósito de un caso en Miranda de Ebro, Burgos / Tularemia: a case report in Miranda de Ebro, Burgos

La tularemia es una de las infecciones emergentes de nuestros días. F. tularensis es un patógeno muy virulento, capaz de iniciar la infección tan sólo con la inoculación de 10 microorganismos. A pesar de que no es una infección frecuente en las consultas de Atención Primaria, es importante su sospecha para realizar un diagnóstico precoz y así adelantarnos a la aparición de nuevos brotes y adoptar oportunas medidas de control (AU)

Tularemia is one of the emerging infections of our times. F. tularensis is a highly virulent pathogen that is capable of initiating the infection with only the inoculation of 10 microorganisms. Although it is not a frequent infection seen in Primary Care consultations, it is important to diagnosis it early and thus anticipate the emergence of new outbreaks and adopt appropriate measures to control it (AU)

[Tularemia, a potential bioterrorism weapon]. / La tularémie, arme potentielle de bioterrorisme.

A POTENTIAL WEAPON: Because of its highly contagious nature with a low inoculum, principally with the biovar A, F. tularensis is considered as an agent that could be used by terrorists, notably when sprayed. Any epidemic of tularemia, essentially in its respiratory form, particularly in areas of low incidence of this infection, should be suspected to be a biowarfare attack. The voluntary contamination of water with this bacteria could also be used as a biological weapon. THE DIFFERENT FORMS OF THE DISEASE: Depend on the mode of contamination, the dose of inoculum and the virulence of the strains. The forms are pulmonary, ulcerous-glandular, typhoid, glandular, ocular-glandular, oropharyngeal and septicemic. IN GENERAL PRACTICE: Tularemia is a disease that requires official notification. Many guidelines exist for the treatment and prophylaxis of patients having been exposed to F. tularensis.

[Gene typing of infectious tularemia strains isolated from the Stavropol and Krasnodar Territories]. / Genotipirovanie shtammov vozbutelia tuliaremii, vydelennykh na territoriiakh Stavropol'skogo i Krasnodarskogo Kraev.

The typing of F. tularensis strains by four variable number of tandem repeats (VNTR) loci has been carried out. Among the strains isolated in the Stavropol and Krasnodar Territories seven genotypes have been detected and their spread in different natural foci has been analyzed. The data thus obtained suggest that the VNTR analysis may become an important instrument for studying the structure of the natural foci of tularemia and evolutionary relationships between individual areas of these foci.

Clinical manifestations of tularemia in Japan--analysis of 1,355 cases observed between 1924 and 1987.

A total of 1,355 cases of tularemia observed between 1924 and 1987 in Japan were viewed on the basis of clinical manifestations and the results were compared with those in the United States. The incubation period varied from one day to over one month. In 75.5% of cases, the symptoms of illness appeared within seven days with the peak on the third day. A sudden onset of flu-like symptoms was generally observed, and 92% of cases was followed by regional lymph node swelling which mostly appeared in axillary and cubital regions. They were observed predominantly at the left rather than the right side. In contrast with the cases in the United States, the number of cases of ulceroglandular type in Japan was only one third of those of glandular type. None of the pleuropulmonary cases or fatal tularemia have been reported in Japan. The number of oropharyngeal cases has remarkably increased after World War II, and is still on the rise, presumably because of the change of dietary habits in Japan. All these characteristics of Japanese tularemia are assumed to be caused by low virulence of Japanese strains of Francisella tularensis.

Immunization against tularemia: analysis of the effectiveness of live Francisella tularensis vaccine in prevention of laboratory-acquired tularemia.

A retrospective analysis was made of cases of laboratory-acquired infections with Francisella tularensis among civilian employees at Fort Detrick, Maryland. The incidence and clinical presentation of tularemia during the decade 1950-1959, when the phenol-killed Foshay vaccine was used routinely for immunization of employees, were compared with similar data from the first decade (1960-1969) after the live tularemia vaccine had come into use. The incidence of typhoidal tularemia fell (from 5.70 to 0.27 cases per 1,000 at-risk employee-years; P less than 0.001), whereas the incidence of ulceroglandular tularemia remained unchanged (from 0.76 to 0.54 cases per 1,000 at-risk employee-years). Ulceroglandular tularemia in employees immunized with live vaccine was characterized by clinical signs and symptoms that were milder than those in employees vaccinated with the Foshay vaccine.

Tularemia

1.-La ¨Tularemia¨existe en bolivia en la zona sud-este presentandose con bastante frecuencia entre los soldados y trabajadores del campo, 2.-Clinicamente la Tuleremia no es facilmente diagnosticable salvo en los casos de epidemia, requisriendose siempre del laboratorio, 3.-La Tuleramia en Bolivia es mas benigna que la descrita en tratados que se refieren a casos extranjeros, pero en cambio la convalescencia es mas larga, 4.-La Tuleremia en Bolivia solo se ha presentado hasta hoy bajo tres formas clìnicas la ganglionar, Ulcero ganglionar y la tifosa, 5.-El sulfatiazol, la sulfopiridina y sulfamilamida no tienen ninguna accion clinica sobre el bacilo de la Tularemia, 6.-El tratamiento Yodo-Ferroso acortando el curso de la enfermedad favorece su evoluciòn benigna, 7.-No existe ningun tratamaiento especìfico hasta la fecha para esta afecciòn