Tularemia: a re-emerging zoonosis.
Medicina clinica·
- DOI
- 10.1016/j.medcli.2026.107565
- PMID
- 42641375
- PMCID
- —
- OpenAlex
- —
- Study type
- Genomic study
- Publisher
- Publisher unavailable
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Tularemia is classified as a CDC Category A bioterrorism agent due to extreme virulence (infection possible with as few as 10 cells) and 30% mortality in untreated cases. The documented re-emergence across multiple Northern Hemisphere regions underscores the need for updated clinical awareness and early diagnostic capacity.
Structured evidence summary
Research question
This review synthesizes current microbiological, epidemiological, clinical, and therapeutic knowledge of tularemia, emphasizing early diagnosis in light of recent re-emergence and the pathogen's epidemic potential.
Study design
Narrative review of tularemia covering microbiology, epidemiology, clinical presentation, and therapeutics with reference to 2025 CDC treatment guidelines and recent molecular diagnostic advances.
Population and setting
The review addresses tularemia cases documented in 2024-2025 across Central Europe (Austria, Slovenia, France), Spain, and the United States, with emphasis on clinical settings requiring early diagnosis.
Main findings
Recent incidence data show 117 cases in Austria, 38 in Slovenia, 150 in France, 206 in Castile and León (Spain), and 220 in the United States during 2024-2025. Molecular diagnostics including PCR and whole genome sequencing have advanced detection capabilities. The 2025 CDC guidelines designate fluoroquinolones and doxycycline as first-line therapies. No licensed human vaccine is currently available, and disease control relies on preventive measures.
Public-health relevance
Tularemia is classified as a CDC Category A bioterrorism agent due to extreme virulence (infection possible with as few as 10 cells) and 30% mortality in untreated cases. The documented re-emergence across multiple Northern Hemisphere regions underscores the need for updated clinical awareness and early diagnostic capacity.
Important limitations
This summary is limited to the supplied single-article abstract and metadata. Full assessment of evidence quality, methodological rigor, and decision-grade interpretation requires access to the complete manuscript.
GIDS interpretation
The article addresses a pathogen with known re-emergence cycles and describes recent case counts from multiple countries. These data may inform understanding of geographic distribution and temporal trends when integrated with other surveillance sources. The review format provides clinical and epidemiological context but does not constitute primary outbreak investigation or signal detection.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 10 auditable classifier relationships to diseases, places, topics, and study design.