Topics in Clinical Microbiology:Francisella tularensis

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Abstract
In 1911, McCoy discovered an unusual illness among ground squirrels in Tulare County, California. The illness resembled plague but was clearly different because a pathogen could not be isolated on the usual culture media. With the addition of egg yolk to the media, McCoy finally isolated an organism and named it Bacterium tularensis. It was soon recognized that B. tularensis could cause disease in humans, and many investigators, especially Edward Francis, did much of the early work defining the bacteriology, pathology, and epidemiology of tularemia. The name of the organism was eventually changed to Francisella tularensis in honor of Francis.Unlike Pseudomonas aeruginosa and the Enterobacteriaceae which are relatively non-pathogenic in the normal host, F. tularensis can easily cause disease in previously healthy persons. In contrast, F. tularensis has not been implicated in nosocomial infections and person to person spread is rare. The organism is, however, extremely hazardous to workers in the clinical microbiology laboratory. Of all common bacterial and fungal pathogens isolated in the clinical laboratory, F. tularensis is second only to Coccidioides immitis in its potential to infect the laboratory worker. Many experienced investigators claim that it is impossible to work with the pathogen for any length of time without becoming infected. Currently it is highly recommended that persons who routinely work with the organism be immunized.

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