Tularemia

Tularemia is an infectious disease caused by the bacterium *Francisella tularensis* ^[1]. It is characterized in the source literature as a zoonotic, arthropod-borne, airborne, food-borne, and water-borne disease ^[1]. The condition is reported to be re-emerging in the Northern Hemisphere, especially in Europe ^[1].

The source review describes six typical clinical pictures: ulceroglandular, glandular, oculoglandular, oropharyngeal, typhoidal, and pneumonic tularemia ^[1]. It also notes that other uncommon presentations may occur and that the disease can potentially affect any body site ^[1]. Tularemia may present as a systemic infectious disease with a pulmonary component, and extrapulmonary manifestations are emphasized in the literature on atypical pneumonias ^[2]. If not promptly diagnosed and treated, fatal outcomes can occur, with the poorest outcomes reported in pneumonic and typhoidal forms ^[1].

The available source material identifies tularemia as re-emerging in the Northern Hemisphere, with particular concern in Europe in recent years ^[1]. It is described as a zoonotic disease, indicating an epidemiologic link to animal reservoirs or animal exposure, although source-backed detail on specific reservoirs is not provided in the snippets ^[1]. The same review frames tularemia as a disease with multiple transmission pathways, which helps explain its varied clinical and outbreak patterns ^[1]. Source-backed detail on incidence, seasonality, or specific high-risk populations is not yet available from the provided snippets ^[1].

Tularemia is reported to spread through several exposure routes: arthropod-borne, airborne, food-borne, and water-borne transmission ^[1]. The review specifically highlights the ease of airborne transmission ^[1]. Source-backed detail on the relative importance of particular vectors, animals, or environmental exposures is not yet available from the provided snippets ^[1].

The provided sources do not specify detailed demographic risk groups, but they do indicate that tularemia is associated with zoonotic exposure and with infection through arthropod, airborne, food, and water pathways ^[1]. Clinically, the pneumonic and typhoidal forms are associated with the poorest outcomes, so patients presenting with these syndromes warrant heightened surveillance attention ^[1]. Source-backed detail on occupational, age-specific, or geographic risk subgroups is not yet available from the snippets ^[1].

Prevention is described as relying on environmental and animal control strategies, proper signaling of clinical suspicion to laboratory staff, and postexposure prophylaxis ^[1]. The source therefore presents prevention as a combination of exposure control and laboratory safety/communication measures rather than a single intervention ^[1]. Source-backed detail on routine vaccination or specific preventive schedules is not yet available from the provided snippets ^[1].

In surveillance settings, tularemia should be interpreted as a re-emerging zoonotic disease with multiple transmission pathways and a wide clinical spectrum ^[1]. The review underscores that airborne spread can be efficient and that severe or fatal disease may occur if diagnosis and treatment are delayed, especially in pneumonic and typhoidal forms ^[1]. The literature also notes that extrapulmonary manifestations are common in atypical pneumonias, which may help contextualize syndromic reporting ^[2].

1. 1 Antonello RM et al. Tularemia for clinicians: An up-to-date review on epidemiology, diagnosis, prevention and treatment. Eur J Intern Med. 2025 May. PMID: 40107886. doi: 10.1016/j.ejim.2025.03.013. PubMed: https://pubmed.ncbi.nlm.nih.gov/40107886/
2. 2 Cunha BA et al. The atypical pneumonias: clinical diagnosis and importance. Clin Microbiol Infect. 2006 May. PMID: 16669925. doi: 10.1111/j.1469-0691.2006.01393.x. PubMed: https://pubmed.ncbi.nlm.nih.gov/16669925/
3. 3 Asano S et al. Granulomatous lymphadenitis. J Clin Exp Hematop. 2012. PMID: 22706525. doi: 10.3960/jslrt.52.1. PubMed: https://pubmed.ncbi.nlm.nih.gov/22706525/
4. 4 Tularemia. Tickborne Infectious Diseases. 2000. doi: 10.1201/b14007-17. DOI: https://doi.org/10.1201/b14007-17
5. 5 Tularemia. Red Book: 2024–2027 Report of the Committee on Infectious Diseases. 2024. doi: 10.1542/9781610027373-s3_019_017. DOI: https://doi.org/10.1542/9781610027373-s3_019_017
6. 6 Tularemia. Encyclopedic Dictionary of Polymers. 2011. doi: 10.1007/978-1-4419-6247-8_15032. DOI: https://doi.org/10.1007/978-1-4419-6247-8_15032

ICD-10

ICD-11

Total cases

2K

Peak month

2021-08

Coverage

6 reporting countries · 2000-01-01 → 2026-06-20