title: Molecular investigation of tularemia outbreaks, Spain, 1997-2008.
abstract: Tularemia outbreaks occurred in northwestern Spain in 1997-1998 and 2007-2008 and affected >1,000 persons. We assessed isolates involved in these outbreaks by using pulsed-field gel electrophoresis with 2 restriction enzymes and multilocus variable number tandem repeat analysis of 16 genomic loci of Francisella tularensis, the cause of this disease. Isolates were divided into 3 pulsotypes by pulsed-field gel electrophoresis and 8 allelic profiles by multilocus variable number tandem repeat analysis. Isolates obtained from the second tularemia outbreak had the same genotypes as isolates obtained from the first outbreak. Both outbreaks were caused by genotypes of genetic subclade B.Br:FTNF002-00, which is widely distributed in countries in central and western Europe. Thus, reemergence of tularemia in Spain was not caused by the reintroduction of exotic strains, but probably by persistence of local reservoirs of infection.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ariza-Miguel
authors.forename: Anders
authors.initials: A
authors.lastname: Johansson
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Fernández-Natal
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez-Nistal
authors.forename: Antonio
authors.initials: A
authors.lastname: Orduña
authors.forename: Elías F
authors.initials: EF
authors.lastname: Rodríguez-Ferri
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández
authors.forename: David
authors.initials: D
authors.lastname: Rodríguez-Lázaro
mesh_terms: D000818:Animals; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005604:Francisella tularensis / Q000145:classification / Q000235:genetics*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D058974:Phylogeography; D013030:Spain / Q000453:epidemiology; D014406:Tularemia / Q000453:epidemiology* / Q000266:history; D015047:Zoonoses / Q000453:epidemiology / Q000266:history
keywords: Francisella tularensis subsp. holarctica; Spain; bacteria; genotyping; molecular investigation; outbreaks; phylogenetics; pulsed-field gel electrophoresis; tularemia; variable number tandem repeat loci; zoonoses
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