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Intratracheal Inoculation of Fischer 344 Rats with Francisella tularensis
Published on: September 30, 2017
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Variation in Tularemia Clinical Manifestations-Arkansas, 2009-2013.
Laura K Lester Rothfeldt1,2, Richard F Jacobs3,4, J Gary Wheeler2,3,4
1Epidemic Intelligence Service, Division of Scientific and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia.
Open Forum Infectious Diseases
|May 9, 2017
Summary
Tularemia cases in Arkansas often present with typhoidal symptoms, not the classic lymphadenopathy. This finding highlights the need for broader clinical suspicion and diagnostic testing for Francisella tularensis in endemic areas.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Francisella tularensis is a naturally occurring bacterium in Arkansas and a potential bioterrorism agent.
- Tularemia is a nationally notifiable disease, requiring mandatory reporting to health departments.
Purpose of the Study:
- To analyze demographic and clinical characteristics of tularemia cases in Arkansas.
- To understand tularemia outcomes and improve epidemiological insights.
Main Methods:
- Review of surveillance records for tularemia cases investigated between 2009 and 2013.
- Assembly of an analytic dataset from 138 probable and confirmed tularemia reports.
Main Results:
- Arthropod bites were reported in 77% of cases.
- The typhoidal form (47%) was more common than lymphadenopathy.
- 41% of patients were hospitalized, and 3% died, with typhoidal cases showing higher severity.
Conclusions:
- Lymphadenopathy is not the most common tularemia manifestation in Arkansas; typhoidal symptoms are more prevalent.
- Relying solely on lymphadenopathy for diagnosis may lead to missed cases.
- Clinicians in endemic areas should maintain high suspicion for tularemia, especially during tick season, and consider the diverse range of symptoms.
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