TY - JOUR AU - Eliasson, Henrik AU - Lindbäck, Johan AU - Nuorti, J. Pekka AU - Arneborn, Malin AU - Giesecke, Johan AU - Tegnell, Anders T1 - The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden T2 - Emerging Infectious Disease journal PY - 2002 VL - 8 IS - 9 SP - 956 SN - 1080-6059 AB - A widespread outbreak of tularemia in Sweden in 2000 was investigated in a case-control study in which 270 reported cases of tularemia were compared with 438 controls. The outbreak affected parts of Sweden where tularemia had hitherto been rare, and these “emergent” areas were compared with the disease-endemic areas. Multivariate regression analysis showed mosquito bites to be the main risk factor, with an odds ratio (OR) of 8.8. Other risk factors were owning a cat (OR 2.5) and farm work (OR 3.2). Farming was a risk factor only in the disease-endemic area. Swollen lymph nodes and wound infections were more common in the emergent area, while pneumonia was more common in the disease-endemic area. Mosquito bites appear to be important in transmission of tularemia. The association between cat ownership and disease merits further investigation. KW - tularemia KW - Sweden KW - Francisella tularensis KW - case-control study KW - epidemiology KW - risk factors DO - 10.3201/eid0809.020051 UR - https://wwwnc.cdc.gov/eid/article/8/9/02-0051_article ER - End of Reference