title: The status of tularemia in Europe in a one-health context: a review.
abstract: The bacterium Francisella tularensis causes the vector-borne zoonotic disease tularemia, and may infect a wide range of hosts including invertebrates, mammals and birds. Transmission to humans occurs through contact with infected animals or contaminated environments, or through arthropod vectors. Tularemia has a broad geographical distribution, and there is evidence which suggests local emergence or re-emergence of this disease in Europe. This review was developed to provide an update on the geographical distribution of F. tularensis in humans, wildlife, domestic animals and vector species, to identify potential public health hazards, and to characterize the epidemiology of tularemia in Europe. Information was collated on cases in humans, domestic animals and wildlife, and on reports of detection of the bacterium in arthropod vectors, from 38 European countries for the period 1992-2012. Multiple international databases on human and animal health were consulted, as well as published reports in the literature. Tularemia is a disease of complex epidemiology that is challenging to understand and therefore to control. Many aspects of this disease remain poorly understood. Better understanding is needed of the epidemiological role of animal hosts, potential vectors, mechanisms of maintenance in the different ecosystems, and routes of transmission of the disease.
authors.affiliation: Department of Pathology and Wildlife Diseases,National Veterinary Institute,Uppsala,Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Hestvik
authors.affiliation: European Center for Disease Prevention and Control,Stockholm,Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Warns-Petit
authors.affiliation: Disease Systems,SRUC,Edinburgh,UK.
authors.forename: L A
authors.initials: LA
authors.lastname: Smith
authors.affiliation: Disease Systems,SRUC,Edinburgh,UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Fox
authors.affiliation: Department of Pathology and Wildlife Diseases,National Veterinary Institute,Uppsala,Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Uhlhorn
authors.affiliation: Université de Lyon,VetAgro Sup,Marcy l'Etoile,France.
authors.forename: M
authors.initials: M
authors.lastname: Artois
authors.affiliation: Faculty of Medicine and Health Sciences,School of Veterinary Medicine and Science, University of Nottingham,UK.
authors.forename: D
authors.initials: D
authors.lastname: Hannant
authors.affiliation: Disease Systems,SRUC,Edinburgh,UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Hutchings
authors.affiliation: Department of Pathology and Wildlife Diseases,National Veterinary Institute,Uppsala,Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Mattsson
authors.affiliation: Faculty of Medicine and Health Sciences,School of Veterinary Medicine and Science, University of Nottingham,UK.
authors.forename: L
authors.initials: L
authors.lastname: Yon
authors.affiliation: Department of Pathology and Wildlife Diseases,National Veterinary Institute,Uppsala,Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Gavier-Widen
mesh_terms: D000818:Animals; D001717:Birds; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology / Q000662:veterinary*; D005060:Europe / Q000453:epidemiology; D005604:Francisella tularensis / Q000302:isolation & purification*; D006801:Humans; D007448:Invertebrates; D008322:Mammals; D019371:Topography, Medical; D014406:Tularemia / Q000453:epidemiology* / Q000382:microbiology / Q000662:veterinary*; D015047:Zoonoses / Q000453:epidemiology* / Q000382:microbiology*
keywords: Animal pathogens; infectious disease; vectors; veterinary epidemiology and bacteriology; zoonoses