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The status of tularemia in Europe in a one-health context: a review

Hestvik, G.; Warns-Petit, E.; Smith, L. A.; Fox, N. J.; Uhlhorn, H.; Artois, M.; Hannant, D.; Hutchings, M. R.; Mattsson, R.; Yon, L.; Gavier-Widen, D.


G. Hestvik

E. Warns-Petit

L. A. Smith

N. J. Fox

H. Uhlhorn

M. Artois

D. Hannant

M. R. Hutchings

R. Mattsson

Associate Professor

D. Gavier-Widen


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.


Hestvik, G., Warns-Petit, E., Smith, L. A., Fox, N. J., Uhlhorn, H., Artois, M., …Gavier-Widen, D. (2015). The status of tularemia in Europe in a one-health context: a review. Epidemiology and Infection, 143(10), 2137-2160.

Journal Article Type Article
Acceptance Date Aug 23, 2014
Online Publication Date Sep 30, 2014
Publication Date 2015-07
Deposit Date Nov 23, 2018
Journal Epidemiology and Infection
Print ISSN 0950-2688
Electronic ISSN 1469-4409
Publisher Cambridge University Press (CUP)
Peer Reviewed Peer Reviewed
Volume 143
Issue 10
Pages 2137-2160
Public URL
Publisher URL
Additional Information Copyright © Cambridge University Press 2014