Is Tularemia Escalating in the U.S.?

Reported mean annual tularemia incidence rose by 56% during the past 10 years relative to the preceding decade — but improvements in diagnostic tests should be taken into account.

Tularemia is a rare but reportable disease in the United States. Francisella tularensis is highly transmissible and, because of its potential for misuse as a bioweapon, has been classified as a tier-1 select agent. Infection can occur by several routes, and symptoms depend on the mode of transmission — with the most common being fever, headache, localized lymphadenopathy, and a skin lesion at the site of inoculation.

During 2011–2022, fully 2462 cases of tularemia were reported in the U.S., an increase from the 1208 reported throughout 2001–2010. Only 40% of these cases were considered to be confirmed (as opposed to probable), defined as a clinically compatible illness with cultured isolates of F. tularensis or fourfold elevated antibody tit…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Is Tularemia Escalating in the U.S.?

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Reviewing Author