TY - JOUR AU - Desvars, Amélie AU - Furberg, Maria AU - Hjertqvist, Marika AU - Vidman, Linda AU - Sjöstedt, Anders AU - Rydén, Patrik AU - Johansson, Anders T1 - Epidemiology and Ecology of Tularemia in Sweden, 1984–2012 T2 - Emerging Infectious Disease journal PY - 2015 VL - 21 IS - 1 SP - 32 SN - 1080-6059 AB - The zoonotic disease tularemia is endemic in large areas of the Northern Hemisphere, but research is lacking on patterns of spatial distribution and connections with ecologic factors. To describe the spatial epidemiology of and identify ecologic risk factors for tularemia incidence in Sweden, we analyzed surveillance data collected over 29 years (1984–2012). A total of 4,830 cases were notified, of which 3,524 met all study inclusion criteria. From the first to the second half of the study period, mean incidence increased 10-fold, from 0.26/100,000 persons during 1984–1998 to 2.47/100,000 persons during 1999–2012 (p<0.001). The incidence of tularemia was higher than expected in the boreal and alpine ecologic regions (p<0.001), and incidence was positively correlated with the presence of lakes and rivers (p<0.001). These results provide a comprehensive epidemiologic description of tularemia in Sweden and illustrate that incidence is higher in locations near lakes and rivers. KW - tularemia KW - Francisella spp. KW - Francisella tularensis KW - Sweden KW - epidemiology KW - vector-borne infections KW - bacteria KW - zoonoses KW - surveillance KW - geographic distribution KW - ecology DO - 10.3201/eid2101.140916 UR - https://wwwnc.cdc.gov/eid/article/21/1/14-0916_article ER - End of Reference