Tularemia - United States, 2011-2022.

Area of Science:

• Zoonotic Diseases
• Infectious Disease Epidemiology
• Public Health Surveillance

Background:

• Tularemia, caused by Francisella tularensis, is a nationally notifiable zoonosis reported across the U.S., except Hawaii.
• Clinical signs vary by infection route, with a case fatality rate typically under 2%, treatable with antibiotics.

Purpose of the Study:

• To analyze national tularemia surveillance data from 2011-2022.
• To identify trends, high-incidence populations, and geographic hotspots for tularemia in the U.S.

Main Methods:

• Analysis of national surveillance data for tularemia cases reported between 2011 and 2022.
• Calculation of incidence rates by age, race/ethnicity, and geographic location.
• Comparison of incidence rates with the previous decade (2001-2010).

Main Results:

• A 56% increase in average annual tularemia incidence was observed from 2011-2022 compared to 2001-2010, largely due to increased probable case reporting.
• Four central states (Arkansas, Kansas, Missouri, Oklahoma) accounted for 50% of cases.
• Highest incidence occurred in children (5-9 years) and older adult males (65-84 years), with American Indian/Alaska Native persons having five times the incidence of White persons.

Conclusions:

• Tularemia incidence has increased, potentially due to actual infections or improved detection.
• Tailored prevention education and enhanced healthcare provider training, especially for tribal populations, are essential for reducing incidence and mortality.