TY - JOUR AU - Staples, J. Erin AU - Kubota, Kristy AU - Chalcraft, Linda AU - Mead, Paul AU - Petersen, Jeannine T1 - Epidemiologic and Molecular Analysis of Human Tularemia, United States, 1964–2004 T2 - Emerging Infectious Disease journal PY - 2006 VL - 12 IS - 7 SP - 1113 SN - 1080-6059 AB - Tularemia in the United States is caused by 2 subspecies of Francisella tularensis, subspecies tularensis (type A) and subspecies holarctica (type B). We compared clinical and demographic features of human tularemia cases from 1964 to 2004 from 39 states in which an isolate was recovered and subtyped. Our data indicate that type A and type B infections differ with respect to affected populations, anatomic site of isolation, and geographic distribution. Molecular subtyping with pulsed-field gel electrophoresis further defined 2 subpopulations of type A (type A-east and type A-west) that differ with respect to geographic distribution, disease outcome, and transmission. Our data suggest that type A-west infections are less severe than either type B or type A-east infections. Through a combined epidemiologic and molecular approach to human cases of tularemia, we provide new insights into the disease for future investigation. KW - Tularemia KW - Francisella tularensis KW - Epidemiology KW - Pulsed-Field Gel Electrophoresis KW - Ecology KW - Vector-borne Diseases KW - United States KW - Research DO - 10.3201/eid1207.051504 UR - https://wwwnc.cdc.gov/eid/article/12/7/05-1504_article ER - End of Reference