Tularemia, 2018

Tularemia is an acute illness caused by Francisella tularensis subspecies tularensis (type A) or holarctica (type B). Routes of transmission include arthropod bites (particularly ticks and deer flies), contact with infected animals, and exposure to contaminated water or soil. There are six main clinical forms of disease and all include fever: ulceroglandular, glandular, pneumonic, oropharyngeal, oculoglandular, and typhoidal.

In 2018, 2 cases were reported; 1 was culture-confirmed, and 1 was a probable case. One case had glandular and the other had pneumonic tularemia. One case had type A tularemia, and the other was diagnosed by serology only and had an unidentified subtype. Case ages were 25 and 69 years old; 1 was male, 1 was female. One case was hospitalized, and both survived. One case likely acquired tularemia by inhaling the bacteria, the other case’s exposure route was unknown.

From 2007 to 2018, 18 tularemia cases were reported, with a range of 0 to 6 cases annually. Ten cases had ulceroglandular, 4 had glandular, 2 had pneumonic, and 2 had typhoidal tularemia. Eight of 13 cases with a known tularemia subtype had type B, and 5 had type A. The median age of cases was 42.5 years (range, 2 to 87). Ten cases were most likely exposed through a tick or biting fly bite, 2 cases through water exposures, 2 cases through a cat scratch or bite, 2 cases were exposed by inhaling the bacteria, and 2 cases’ exposures could not be determined. Thirteen of 16 cases for which race was known were white, 1 was black, and 1 was American Indian/ Alaska Native, and 1 was Asian/Pacific Islander.

• For up to date information see>> Tularemia
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2018