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68 - Tularemia

from Part IV - Current Topics

Published online by Cambridge University Press:  15 December 2009

By
David M. Stier ,
Jennifer C. Hunter ,
Olivia Bruch  and
Karen A. Holbrook
Edited by
Rachel L. Chin
David M. Stier
Affiliation:
Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Jennifer C. Hunter
Affiliation:
Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Olivia Bruch
Affiliation:
Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Karen A. Holbrook
Affiliation:
Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

Tularemia is a zoonotic disease caused by Francisella tularensis, a nonsporulating, nonmotile, aerobic, gram-negative coccobacillus. There are several subspecies of F. tularensis, with the biovars tularensis (type A) and holarctica (type B) occurring most commonly in the United States. The clinical syndromes caused by tularemia depend on the route of infection and subspecies of the infecting organism. Tularemia is highly infectious, requiring inhalation or inoculation of as few as 10 organisms to cause disease. Although its virulence factors are not well characterized, type A is generally thought to be the more virulent subspecies. However, the virulence of type A subspecies may vary between geographic regions within the United States, with the midwestern and eastern states having more severe infections.

The Working Group for Civilian Biodefense considers tularemia to be a dangerous potential biological weapon because of its “extreme infectivity, ease of dissemination, and its capacity to cause illness and death.” Of the potential ways that F. tularensis could be used as a biological weapon, an aerosol release is expected to have the most severe medical and public health outcomes.

EPIDEMIOLOGY

Tularemia as a Biological Weapon

Weaponized F. tularensis was developed and stockpiled by the U.S. military, though the supply was destroyed in the 1970s. The Soviet Union is reported to have developed antibiotic- and vaccine-resistant strains of weaponized F. tularensis.

Experts believe that an aerosolized release is the most likely intentional use of F. tularensis organisms.

Type
Chapter
Information
Emergency Management of Infectious Diseases , pp. 451 - 458
Publisher: Cambridge University Press
Print publication year: 2008

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References

American Public Health Association. Tularemia. In: Chin, J, ed, Control of communicable diseases manual. Washington, DC: Author, 2000:532–5.Google Scholar
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Barry, M A. Report of pneumonic tularemia in three Boston University researchers. Boston Public Health Commission, 2005. Available at: http://www.bphc.org/reports/pdfs/report_202.pdf.Google Scholar
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  • Tularemia
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.069
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Tularemia
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.069
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Tularemia
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.069
Available formats
×