ARCHIVED - Tularemia

 


Nationally notifiable since 2002

1.0 National Notification

Only confirmed cases of disease should be notified.

2.0 Type of Surveillance

Routine case-by-case notification to the federal level

3.0 Case Classification

3.1 Confirmed case

Clinical illness (see section 5.0) with laboratory confirmation of infection:

  • isolation of Francisella tularensis from an appropriate clinical specimen
    OR
  • a significant (e.g. fourfold or greater) change in serum antibody titre to F. tularensis antigen

3.2 Probable case

Clinical illness with laboratory evidence:

  • detection of F. tularensis in a clinical specimen by fluorescent assay OR
  • detection of F. tularensis nucleic acid
    OR
  • ≥ 1:128 microagglutination titre or ≥ 1:160 tube agglutination in a single serum specimen

4.0 Laboratory Comments

5.0 Clinical Evidence

Clinical diagnosis is supported by evidence or history of a tick or deerfly bite, exposure to the tissues of a mammalian host of Francisella tularensis or exposure to potentially contaminated water.

Clinical illness is characterized by several distinct forms:

Ulceroglandular:
cutaneous ulcer with regional lymphadenopathy
Glandular:
regional lymphadenopathy with no ulcer; oculoglandular conjunctivitis with preauricular lymphadenopathy; oropharyngeal stomatitis or pharyngitis; or tonsillitis and cervical lymphadenopathy
Intestinal:
intestinal pain, vomiting, and diarrhea; pneumonic primary pleuropulmonary disease; typhoidal febrile illness without early localizing signs and symptoms

6.0 ICD Code(s)

6.1 ICD-10 Code(s)

A21
Tularaemia (includes: deer-fly fever, infection due to Francisella tularensis, rabbit fever)
A21.0
Ulceroglandular tularaemia
A21.1
Oculoglandular tularaemia (Ophthalmic tularaemia)
A21.2
Pulmonary tularaemia
A21.3
Gastrointestinal tularaemia (Abdominal tularaemia)
A21.7
Generalized tularaemia
A21.8
Other forms of tularaemia
A21.9
Tularaemia, unspecified

6.2 ICD-7 Code(s)

7.0 Type of International Reporting

8.0 Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

9.0 References

Date of Last Revision/Review:

May 2008


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