An Outbreak of Primary Pneumonic Tularemia on Martha's Vineyard

• Published in: The New England journal of medicine Vol. 345; no. 22; pp. 1601 - 1606
• Main Authors: Feldman, Katherine A, Enscore, Russell E, Lathrop, Sarah L, Matyas, Bela T, McGuill, Michael, Schriefer, Martin E, Stiles-Enos, Donna, Dennis, David T, Petersen, Lyle R, Hayes, Edward B
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 29.11.2001
• Subjects: Adolescent; Adult; Animals; Antibodies, Bacterial - blood; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Case-Control Studies; Disease Outbreaks; Female; Francisella tularensis; Francisella tularensis - immunology; Francisella tularensis - isolation & purification; General aspects; Human bacterial diseases; Humans; Infections; Infectious diseases; lawn mowing; Male; Massachusetts - epidemiology; Medical sciences; Mephitidae - microbiology; Mortality; outbreaks; Planification. Prevention (methods). Intervention. Evaluation; Pneumonia, Bacterial - epidemiology; pneumonic tularemia; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rats - microbiology; Risk Factors; Tularemia; Tularemia - epidemiology; United States; North America; Massachusetts; America; Cape Cod Massachusetts; United States > US; Arkansas; Missouri; USA, Massachusetts, Martha's Vineyard; Human; Lung disease; Respiratory disease; Lung; Tularemia; Case control study; Infection; Outbreak; Risk factor; Bacteriosis; Bacteria; Adult; Field inquiry; Public health; Francisella tularensis
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa011374

In the summer of 2000, there was an outbreak of tularemia on the island of Martha's Vineyard in Massachusetts. This case–control study identified 15 patients with Francisella tularensis infection, including 11 with primary pneumonic tularemia. One patient died. The patients were more likely than controls to have used a lawn mower or brush cutter in the two weeks before the illness. Tularemia is a bacterial zoonosis caused by the small, gram-negative coccobacillus Francisella tularensis . The organism may be found in contaminated water or soil, infected ticks, wild and domestic animals, and decaying animal carcasses. Mammals can acquire the infection through arthropod bites, direct contact with infected tissues, inhalation, or ingestion; person-to-person transmission has not been documented. After an incubation period of 3 to 5 days (range, 1 to 21), infection with F. tularensis can result in various clinical presentations, depending on the route of inoculation, the dose of the inoculum, and the virulence of the organism. Primary pneumonic tularemia results . . .