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Volume 16, Number 2—February 2010

Research

Investigating an Airborne Tularemia Outbreak, Germany

Anja M. HauriComments to Author , Iris Hofstetter, Erik Seibold, Philip Kaysser, Juergen Eckert, Heinrich Neubauer, and Wolf D. Splettstoesser1
Author affiliations: Hesse State Health Office, Dillenburg, Germany (A.M. Hauri); Public Health Authority Darmstadt-Dieburg, Darmstadt, Germany (I. Hofstetter, J. Eckert); National Reference Laboratory for Tularemia, Munich, Germany (E. Seibold, P. Kaysser, W.D. Splettstoesser); Institute of Bacterial Zoonoses, Jena, Germany (H. Neubauer).

Main Article

Table 2

Attack rates among exposed and nonexposed hare hunters, according to potential risk factors for Francisella tularensis infection, Germany, 2005*

Potential risk factor Exposed
Not exposed
RR (95% CI) p value
No. cases No. hunters Attack rate, % No. cases No. hunters Attack rate, %
Hunted 8 27 29.6 2 10 20.0 1.5 (0.4–5.8) 0.45
Had direct contact with dead hares 10 34 29.4 0 4 0 0.2
Wore gloves during contact with dead hares 2 5 40.0 8 21 38.1 1.5 (0.4–4.9) 0.6
Injured skin 4 8 50.0 5 25 20.0 2.5 (0.9–7.1) 0.12
Disemboweled hares 7 11 63.6 3 27 11.1 5.7 (1.8–18.2) 0.002
Injured while disemboweling hares 1 2 50.0 9 36 25.0 2.0 (0.5–8.9) 0.46
Rinsed hares at the lodge 4 6 66.7 6 32 18.8 3.6 (1.4–8.9) 0.03
Presence within 5 m of where disemboweled hares were rinsed 9 11 81.8 1 27 3.7 22.1 (3.2–154.3) <0.0001
Skinned hares 5 9 55.6 5 29 17.2 3.2 (1.2–0.7) 0.04
Injured while skinning hares 1 1 100 9 37 24.3 4.1 (2.3–7.3) 0.26
Had contact with raised dust 4 5 80.8 6 33 18.2 4.4 (1.9–10.3) 0.01
Had contact with puddle or ditch water 0 1 0 10 37 27.0 0.74
Received tick bite on the hunting day 0 0 10 38 26.3
Consumed hares hunted on October 29, 2005 0 4 0.0 10 34 29.4 0.28
Attended the common lunch/supper 9 35 25.7 1 3 33.3 0.8 (0.0–4.2) 0.61
Stayed abroad in October 2005 4 7 57.1 6 30 20.0 2.9 (1.1–7.5) 0.07

*RR, risk ratio; CI, confidence interval. Totals vary because of answers of “do not know.”

Main Article

1Current affiliation: University Hospital Rostock, Rostock, Germany.

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