TULARAEMIA
(Francisella tularensis)

Clinical Criteria
Any person with at least one of the following clinical forms:
- Ulceroglandular tularaemia
– Cutaneous ulcer
AND
– Regional lymphadenopathy

- Glandular tularaemia
– Enlarged and painful lymph nodes without apparent ulcer

- Oculoglandular tularaemia
– Conjunctivitis
AND
– Regional lymphadenopathy

- Oropharyngeal tularaemia
– Cervical lymphadenopathy
AND at least one of the following three:
– Stomatitis
– Pharyngitis
– Tonsillitis

- Intestinal tularaemia
At least one of the following three:
– Abdominal pain
– Vomiting
– Diarrhoea

- Pneumonic tularaemia
– Pneumonia

- Typhoidal tularaemia
At least one of the following two:
– Fever without early localising signs and symptoms
– Septicaemia

Laboratory Criteria
At least one of the following three:
– Isolation of Francisella tularensis from a clinical specimen
– Detection of Francisella tularensis nucleic acid in a clinical specimen
– Francisella tularensis specific antibody response

Epidemiological Criteria
At least one of the following three epidemiological links:
– Exposure to a common source
– Animal to human transmission
– Exposure to contaminated food / drinking water

Case Classification
A. Possible case    NA
B. Probable case
Any person meeting the clinical criteria and with an epidemiological link
C. Confirmed case
Any person meeting the clinical and the laboratory criteria