Tularemia epidemiology and demographics: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
[[Image:Geographic Distribution.jpg|thumb|left|Geographic distribution of Tularemia]] | |||
*Tularemia occurs throughout much of North America and Eurasia. In the U.S., human cases have been reported from every state except Hawaii, with the majority occurring in south-central and western states. | |||
*F. tularensis is found in widely diverse animal hosts and habitats and can be recovered from contaminated water, soil, and vegetation. A variety of small mammals, including voles, mice, water rats, squirrels, rabbits, and hares are natural reservoirs of infection. They acquire infection through [[tick]], fly, and mosquito bites and by contact with contaminated environments. Epizootics with sometimes extensive die-offs of animal hosts may herald outbreaks of tularemia in humans. | |||
*Humans can become incidentally infected through diverse environmental exposures: bites by infected arthropods; handling infectious animal tissues or fluids; direct contact with or ingestion of contaminated food, water, or soil; and inhalation of infective aerosols. Humans can develop severe and sometimes fatal illness, but do not transmit the disease to others. | |||
*The high incidence of tularemia among males and among children aged <10 years might be associated with increased opportunity for exposure to infected ticks or animals, less use of personal protective measures against tick bites, or diagnostic or reporting bias. The high incidence among American Indians/Alaska Natives might be associated with their increased risk for exposure; outbreaks of tularemia have been reported on reservations in Montana and South Dakota, where a high prevalence of tularemia infection was found in ticks and dogs. | |||
*Worldwide incidence of naturally occurring tularemia is unknown. It is likely that the disease is greatly under-recognized and under-reported. In the U.S., reported cases have dropped sharply from several thousand/year prior to 1950 to fewer than 200/year in the 1990s. Between 1985 and 1992, 1409 cases and 20 deaths were reported in the U.S., a case fatality rate of 1.4%. Most U.S. cases occur June–September, when arthropod-borne transmission is most common. Cases in winter most commonly occur among hunters and trappers who handle infected animal carcasses. | |||
*Release in a densely populated area would be expected to result in an abrupt onset of large numbers of acute, nonspecific [[febrile]] illness beginning 3–5 days later (incubation range 1–14 days), with [[pleuropneumonitis]] developing in a significant proportion of cases during the ensuing days and weeks.<ref>http://www.bt.cdc.gov/agent/tularemia/tularemia-biological-weapon-abstract.asp#2</ref> <ref>http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5109a1.htm</ref>. | |||
==References== | ==References== | ||
Revision as of 21:33, 10 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Epidemiology and Demographics
- Tularemia occurs throughout much of North America and Eurasia. In the U.S., human cases have been reported from every state except Hawaii, with the majority occurring in south-central and western states.
- F. tularensis is found in widely diverse animal hosts and habitats and can be recovered from contaminated water, soil, and vegetation. A variety of small mammals, including voles, mice, water rats, squirrels, rabbits, and hares are natural reservoirs of infection. They acquire infection through tick, fly, and mosquito bites and by contact with contaminated environments. Epizootics with sometimes extensive die-offs of animal hosts may herald outbreaks of tularemia in humans.
- Humans can become incidentally infected through diverse environmental exposures: bites by infected arthropods; handling infectious animal tissues or fluids; direct contact with or ingestion of contaminated food, water, or soil; and inhalation of infective aerosols. Humans can develop severe and sometimes fatal illness, but do not transmit the disease to others.
- The high incidence of tularemia among males and among children aged <10 years might be associated with increased opportunity for exposure to infected ticks or animals, less use of personal protective measures against tick bites, or diagnostic or reporting bias. The high incidence among American Indians/Alaska Natives might be associated with their increased risk for exposure; outbreaks of tularemia have been reported on reservations in Montana and South Dakota, where a high prevalence of tularemia infection was found in ticks and dogs.
- Worldwide incidence of naturally occurring tularemia is unknown. It is likely that the disease is greatly under-recognized and under-reported. In the U.S., reported cases have dropped sharply from several thousand/year prior to 1950 to fewer than 200/year in the 1990s. Between 1985 and 1992, 1409 cases and 20 deaths were reported in the U.S., a case fatality rate of 1.4%. Most U.S. cases occur June–September, when arthropod-borne transmission is most common. Cases in winter most commonly occur among hunters and trappers who handle infected animal carcasses.
- Release in a densely populated area would be expected to result in an abrupt onset of large numbers of acute, nonspecific febrile illness beginning 3–5 days later (incubation range 1–14 days), with pleuropneumonitis developing in a significant proportion of cases during the ensuing days and weeks.[1] [2].