Tularemia - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

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Please note you've to add our email mailer bookmail. Read more. Post a Review. In recent decades, an explosion in the amount of basic research focused on understanding and treating tularemia has occurred due to concern about the intentional misuse of F. Research studies using virulent F.

In contrast, the F. Information about select agent exemptions for F. The less stringent containment requirement for F. To date, the appropriate nomenclature for F. While F. As a result, a variety of names including, but not limited to, F. This lack of standardized terminology is further complicated by non-enforcement of consistent nomenclature by journals and editors.

It is particularly problematic when trying to interpret published experimental results obtained using F. Another negative outcome of the proposed classification of F. In order to support maintaining separate species designations for F. We also discuss the utility of F.

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Table 1. Genetic and phenotypic differences between F. Studies in human volunteers in the s demonstrated that infection was established with as few as 25 organisms when aerogenically exposed to F. Between these two subspecies, disease outcome and geographic distribution differs Olsufiev et al. Human infection due to a third subspecies, F. Within both F. In the case of F.

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Among patients infected with A1b strains, significantly higher fatality rates were observed as compared to those patients infected with A1a or A2 strains Kugeler et al. The higher mortality rate for infection with an A1b strain was not associated with host factors age, sex, underlying illness , indicating an intrinsic characteristic of A1b strains i. Humans acquire infections by a variety of different mechanisms, including arthropod bites ticks, flies, mosquitoes , direct contact with infected animals e.

For all forms, fever and acute symptoms are hallmarks of tularemia in healthy individuals. Arthropod transmission of F. Skinning infected animals also leads to ulceroglandular tularemia. Other forms of tularemia include oculoglandular tularemia, acquired via direct inoculation of the eye; oropharyngeal tularemia, acquired through ingestion of water or food contaminated by infected animals; and pneumonic respiratory tularemia, acquired through inhalation of infective aerosols during landscaping, farming, or laboratory activities.

It is the pneumonic form of tularemia that is the most severe and of highest concern with respect to an intentional aerosol event Dennis et al. In comparison to F. Only 12 cases have been documented Hollis et al. Illness caused by F. Clinical information available for 11 reported cases indicate that 9 of the F. Fever and acute disease, hallmarks of tularemia in healthy individuals, were only observed for F.

In the two healthy individuals with F. Classic forms of tularemia, including ulceroglandular, pneumonic, oropharyngeal, and oculoglandular, have not been observed for F. Given the rarity of F. Reported human infections are associated with uncertain routes of exposure. For those cases where the mode of infection was ascertained, two cases were due to near-drowning events in salt water and three cases were associated with environmental contamination of outdoor ice machines Brett et al. No evidence exists to suggest that F.

In nature, F. As an intracellular pathogen, F.

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The bacterium is most often associated with lagomorphs and rodents, including voles, squirrels, and beavers. Maintenance of F. In contrast to F. Moreover, in the case of arthropods, the lack of identification of F. As arthropod vectors characteristically acquire infection from bacteremic animal hosts, the lack of identification of F.

It is likely that F. Indeed, the sole source of F. This includes the F. Additional environmental sources of F. Genome sequencing has been performed on several F. Despite this high degree of nucleotide identity, differences are apparent between their respective genomes. The genome size of F. Selective genome reduction in the intracellular pathogen F.

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In contrast, only 14 pseudogenes are evident in the F. Larsson et al. Frequently it is components of metabolic pathways that are deleted during the transition to an intracellular pathogen, as the nutrients can be acquired from the host. Indeed, metabolic differences between F. More recently, Huber et al. Genomic analyses of F.

The F. For example, F. The majority of genes encoding restriction barrier systems in F. This evolutionary phenomenon is also present in strains of increasing virulence in both Yersinia and Burkholderia Ong et al. Another example of F. Overproduction of cdGMP in F. The absence of these genes in F.

Gene amplification is evidenced in F. Most notably, genomic analyses of F. Deletion of most genes within the FPI of both F. Given the importance of the FPI for intracellular replication and virulence, it seems likely duplication in F. Only 7 genes unique to F.

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All 7 genes are predicted to encode components necessary for the outer surface of F. The wbtJ gene of F. Genomic analyses indicate that F. Additionally, the F. Genome decay due to IS element proliferation is clear in F. IS element proliferation in F. Between F. Overall, these findings are consistent with the idea that niche restricted bacteria, such as intracellular pathogens, tend to have monomorphic genomes, whereas environmental bacteria are under weaker purifying selection and therefore retain the capacity to adapt to differing conditions by undergoing genomic changes Moran, ; Achtman, ; Larsson et al.

The differing virulence between F. Variation in the time-to-death of F.

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Summarized in this section are results of virulence testing for F. We note that the intent of this section is not to discuss the merits of using one animal model over another for tularemia research. Both mice and guinea pigs are highly susceptible to F. Differences in time to death of infected mice are also detected between subpopulations of F. In contrast to mice and guinea pigs, virulence is markedly different in rabbits between F.

When introduced subcutaneously, an LD of 1 organism is observed for F.