Tularemia (Francisella tularensis)

Clinical criteria
Any person with at least one of the following clinical forms:

- Ulceroglandular tularemia

- Cutaneous ulcer
AND
- Regional lymphadenopathy

- Glandular tularemia

- Enlarged and painful lymph nodes without apparent ulcer

- Oculoglandular tularemia

- Conjunctivitis
AND
- Regional lymphadenopathy

- Oropharyngeal tularemia

- Cervical lymphadenopathy
AND
at least one of the following three:
- Stomatitis
- Pharyngitis
- Tonsillitis

- Intestinal tularemia
At least one of the following three:

- Abdominal pain
- Vomiting
- Diarrhoea

- Pneumonic tularemia

- Pneumonia

- Typhoidal tularemia
At least one of the following two:

- Fever without early localising signs and symptoms
- Septicaemia

Laboratory criteria
At least one of the following three:
- Isolation of Francisella tularensis from a clinical specimen
- Detection of Francisella tularensis nucleic acid in a clinical specimen
- Francisella tularensis specific antibody response

Epidemiological criteria
At least one of the following three epidemiological links:
- Exposure to a common source
- Animal to human transmission
- Exposure to contaminated food/drinking water

Case classification
A. Possible case
NA
B. Probable case
Any person meeting the clinical criteria and with an epidemiological link
C. Confirmed case
Any person meeting the clinical and the laboratory criteria

Current as of: 7 March 2019