Tularemia historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.
Overview
Franciscella tularensis was first discovered by George Walter McCoy in 1911. The organism was originally named Bacterium tularense, after Tulare county where the causative agent was first discovered. Expounding upon McCoy's previous research, Dr. Edward Francis furthered global understanding of tularemia, through the discovery of animal reservoirs, vectors, and clinical manifestations. The ailment soon became frequent with hunters, cooks and agricultural workers.[1] Tularemia was later identified as a potential tool for bio-terrorism.
Historical Perspective
Documented outbreaks
- Tularemia was first documented by George Walter McCoy in 1911 and later isolated in 1912.
- The disease was classified as a severe and fatal with the capability of persisting as a human illness.
- First human case confirmed in Cincinnati in 1914.
- In 1928 Dr. Edward Francis began to identify vectors, animal reservoirs, clinical manifestations associated with tularemia infection.
- In 1959, scientists from Russia discovered two distinct strains of tularemia: type A and type B.
- From 1966 to 1967 an epidemic of tularemia was announced in Sweden.
- Another outbreak of tularemia occurred in Kosovo between the years 1999-2000[2]
- In summer 2000, an outbreak of tularemia in Martha's Vineyard resulted in one fatality, and brought the interest of the CDC as a potential investigative ground for aerosol based Francisella tularensis.
- Over the following summers, Martha's Vineyard was identified as the only place in the world where documented cases of tularemia resulted from lawn mowing.[3] The research may prove valuable in preventing bio-terrorism.
- In 2004, three researchers at Boston University Medical Center were accidentally infected with F. tularensis, after apparently failing to follow safety procedures.[4]
- In 2005, small amounts of F. tularensis were detected in the Mall area of Washington, DC the morning after an anti-war demonstration on September 24, 2005. Bio-hazard sensors were triggered at six locations surrounding the Mall. To this date, no cases of tularemia infection have been reported as a result.[5]
- In July 2007, an outbreak was reported in the Spanish autonomous region of Castile and León and traced to the plague of voles infesting the region.
Tularemia as a biological weapon
- The Centers for Disease Control and Prevention regard F. tularensis as a viable bio-weapon. The disease was used as a weapon by the Russians during World War II. [6] Practical research into using Tularemia as a bio-weapon took place at Camp Detrick in the 1950s. It was viewed as an attractive agent because:
- it is easily condensed into an aerosol form
- it is highly infectious; fewer than 10 bacteria are required to infect
- it is non-persistent and easy to decontaminate (unlike anthrax)
- it is highly incapacitating to infected persons
- it is rarely lethal, which is useful when enemy soldiers are in close proximity to non-combatants and civilians
- No vaccine is available to the general public.[7] The best way to prevent tularemia infection is to wear rubber gloves when handling or skinning rodents or lagomorphs (as rabbits), avoid ingesting uncooked wild game and untreated water sources, and wearing long-sleeved clothes and using an insect repellant to prevent tick bites.
Biological Warfare
- By the late 1950's the US biological warfare program was focused mostly on tularemia as a biological agent.
- Schu S4 strain was standardized as Agent UL for use in the M143 bursting spherical bomblet.
- It was a lethal, with an anticipated fatality rate of 40 to 60 percent.
- The rate-of-action was around three days, with a duration-of-action of 1 to 3 weeks (treated) and 2 to 3 months (untreated) with frequent relapses. UL was streptomycin resistant.
- Aerobiological stability of UL was a major concern, being sensitive to sun light, and losing virulence over time after release.
- The United States later changed the military symbol for UL to TT (wet-type) and ZZ (dry-type) in an effort to retain security on the identity of military bio-hazards. When the 425 strain was standardized as agent JT (something to incapacitate rather than lethal agent), the Schu S4 strain's symbol was changed again to SR.
References
- ↑ English Pravda. Tularemia. http://english.pravda.ru/main/18/90/363/14923_tularemia.html
- ↑ Centers for Disease Control and Prevention. NCIDOD. http://www.cdc.gov/ncidod/eid/vol8no1/01-0131.htm
- ↑ Feldman KA, Enscore R, Lathrop S, et al. Outbreak of primary pneumonic tularemia on Martha's Vineyard. N Engl J Med 2001;345:1601--6.
- ↑ Smith S (2005-03-29). "City tells BU to bolster safety of its medical labs". Boston Globe. Retrieved 2007-05-09.
- ↑ Dvorak P (2005-10-2). "Health Officials Vigilant for Illness After Sensors Detect Bacteria on Mall: Agent Found as Protests Drew Thousands of Visitors". Washington Post. p. C13. Retrieved 2007-05-08.
A week after six bioterrorism sensors detected the presence of a dangerous bacterium on the Mall, health officials said there are no reports that any of the thousands of people in the nation's capital Sept. 24 have tularemia, the illness that results from exposure to the bacteria.
Check date values in:|date=(help) - ↑ English Parvda Tularemia. http://english.pravda.ru/main/18/90/363/14923_tularemia.html
- ↑ http://www.niaid.nih.gov/factsheets/tularemia.htm