Landscape Epidemiology of Tularemia Outbreaks in Sweden
Kerstin Svensson, Erik Bäck, Henrik Eliasson, Lennart Berglund, Malin Granberg, Linda Karlsson, Pär Larsson, Mats Forsman, and Anders Johansson
Author affiliations: Swedish Defense Research Agency, Umeå, Sweden (K. Svensson, M. Granberg, L. Karlsson, P. Larsson, M. Forsman, A. Johansson); Umeå University, Umeå (K. Svensson, A. Johansson); Örebro University Hospital, Örebro, Sweden (E. Bäck, H. Eliasson); Ljusdal Healthcare Centre, Ljusdal, Sweden (L. Berglund); Umeå University Hospital, Umeå (A. Johansson)
Figure 7. A) Directional distributions of tularemia transmission sites in Ljusdal, Sweden, by outbreak year (red ellipses). The Francisella tularensis isolates recovered from patients in Ljusdal were genetically monomorphic, with 53/56 isolates belonging to genetic subgroup 1e (solid black ellipse). The dashed black ellipse represents the distributions of all 56 isolates. Each ellipse represents a 1 standard deviation distribution around the mean centers of occurrence (starred). B) Distributions of 13 isolates of genetic group 1e, genotype identification (ID) 15 (red), Ljusdal, 1995. C) Distributions of 26 isolates of genetic group 1e, genotype ID 15 (red) and genotype ID 16 (black), Ljusdal, 1998. Numbers above symbols indicate multiple data points. D) Distributions of 13 isolates of genetic group 1e, genotype ID 15 (red) and genotype ID 16 (black); genetic group 1b (green); genetic group 1c (gray); and genetic group 3 (white), Ljusdal, 2005. Spatial data quality assessment for each pair of coordinates is shown as certain (circle), probable (square), or possible (diamond); patient residency (triangle) was used when transmission data were unavailable.
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.