Tularemia: Current epidemiology and disease management

Tularemia, caused by the gram-negative bacterium Francisella tularensis, a zoonosis with a complex epidemiology, is transmitted to humans by vectors, direct contact, inhalation, or the alimentary route. Increasing knowledge, on the subspecies level, of pathogenicity, ecology, and epidemiology is being elucidated as a result of intensified research. A low infective dose of the bacterium in combination with a high attack rate via the respiratory route causes concern over its possible use as a bioterrorism agent. Fluoroquinolone therapy is an alternative to aminoglycoside treatment.