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Landscape epidemiology of tularemia outbreaks in Sweden
Örebro University, School of Health and Medical Sciences.
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2009 (English)In: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, no 12, p. 1937-1947Article in journal (Refereed) Published
Abstract [en]

Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km(2), indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients' statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks.

Place, publisher, year, edition, pages
2009. Vol. 15, no 12, p. 1937-1947
National Category
Medical and Health Sciences Infectious Medicine
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-12124DOI: 10.3201/eid1512.090487PubMedID: 19961673OAI: oai:DiVA.org:oru-12124DiVA: diva2:355650
Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12Bibliographically approved

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Bäck, ErikEliasson, Henrik

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