Tularaemia - Centers for Disease Control and Prevention

BSA bovine serum albumin. CA enriched chocolate agar. CFU colony-forming unit. DNA deoxyribonucleic acid. ELISA enzyme-linked immunosorbent assay.
4MB Sizes 43 Downloads 383 Views
Tularaemia is a bacterial zoonotic disease of the northern hemisphere. The bacterium (Francisella tularensis) is highly virulent for humans and a range of animals such as rodents, hares and rabbits. Humans can infect themselves by direct contact with infected animals, by arthropod bites, by ingestion of contaminated water or food, or by inhalation of infective aerosols. There is no human-to-human transmission. In addition to its natural occurrence, F. tularensis evokes great concern as a potential bioterrorism agent. F. tularensis subspecies tularensis is one of the most infectious pathogens known in human medicine. In order to avoid laboratory-associated infection, safety measures are needed and consequently, clinical laboratories do not generally accept specimens for culture. However, since clinical management of cases depends on early recognition, there is an urgent need for diagnostic services.

WHO guidelines On tularaemia

This first edition of the WHO guidelines on tularaemia is the result of an international collaboration, initiated at a WHO meeting in Bath, UK in 2003. The target audience includes clinicians, laboratory personnel, public health workers, veterinarians, and any other person with an interest in zoonoses.

WHO GUIdelInes On


The book provides background information on the disease, describes the current best practices for its diagnosis and treatment in humans, suggests measures to be taken in case of epidemics and provides guidance on how to handle F. tularensis in the laboratory.

isBn 978 92 4 154737 6


EpidEmic and pandEmic alErt and rEsponsE

WHO Guidelines on


EpidEmic and pandEmic alErt and rEsponsE

WHO Library Cataloguing-in-Publication Data WHO Guidelines on Tularaemia. 1.Francisella tularensis – classification. 2.Tularemia – epidemiology. 3.Tularemia – transmission. 4.Tularemia – drug therapy. I.World Health Organization.

ISBN 978 92 4 154737 6

© World Health Organization 2007

(NLM classification: WC 380)


All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in France


Contents Acknowledgements Abbreviations



1. Introduction 2. The infectious agent 2.1