Tularemia outbreak detected in Norway

An outbreak of tularemia, a bacterial zoonosis caused by Francisella tularensis, which is one of the most pathogenic bacteria known, has been reported in Norway, causing 39 cases from January through March.  

While tularemia is a candidate for use in a terrorist attack as a biological pathogen, those studying the outbreak believe that most of the infections came from those drinking from a contaminated private well water source, Euro Surveillance reports.

Thirty-four of the cases drank water from private wells. Twenty-one of the cases were of the oropharyngeal type, 10 were cases of the ulceroglandular/glandular type, two were of the typhoid type and two were of the respiratory type.

A theory on the outbreak is that an increased population of lemmings and the melting of snow may have led to a contamination of the wells with infected rodents or rodent excreta, according to Euro Surveillance.

The Norway Institute of Public Health has issued guidelines that the population should boil their drinking water and inspect their wells for dead rodents in the case of suspected or confirmed cases of tularemia that are waterborne. Well owners are also advised to carefully cover every opening and plug every small hole from which an infected rodent might enter.

According to an abstract reprinted by the CDC, tularemia could be used as a biological weapon and would likely have the greatest adverse public and medical health consequences if released through the air. Treatment with antimicrobial drugs like streptomycin is usually recommended for those infected between 10 and 21 days.