A Tularemia Outbreak of Historical Proportions in the Norrbotten County, Sweden (nr. 1434) Tomas N Gustafsson, MD, PhD (1,2)*, Anders Nystedt, MD (1,3) (1)Infectious Disease Clinic, Sunderby Hospital, Luleå, Sweden, (2) Department of Clinical Microbiology, Umeå University, Umeå, Sweden, (3) Unit for Disease Prevention and Control, Sunderby Hospital, Luleå, Sweden (*)Presenting and corresponding author (
[email protected]) Introduction Results Distribution of clinical forms – the ulceroglandular form was predominant Tularemia, which is caused by the bacterium Francisella tularensis, exist in The largest outbreak in the Norrbotten County. several different forms; ulceroglandular, occuloglandular, typhoid (septic), r 450 pulmonary and oropharyngeal. Sweden experiences recurrent outbreaks with a 3 Oropharyngeal e The incidence varies widely As expected, the y 400 irregular intervals and geographical localizations. Although infections with 32 Pulmonary r between years as illustrated e 350 47 Typhoid ulceroglandular form the type B strains found in Sweden does not normally result in fatalaties, they p 300 for the last 20 years. The 406 324 Ulceroglandular dominted with almost 80% s cause significant morbidity unless treated early. Infections are normally e cases of 2015 is a doubling of s 250 of reported cases. There treated with ciprofloxacin or doxycycline although aminoglycosides can be a c 200 the previous high in the year were no reported used. The infection is classified as notifiable under the Swedish f o of 2012 and puts it amongst 150 occuloglandular cases. Communicable Diseases Act. r e 100 the largest outbreaks in b The Norrbotten County is the largest and northernmost county in Sweden m 50 Sweden during the period for u and is situated around the arctic circle.