European Journal of Pediatrics

, Volume 168, Issue 8, pp 937–940

Ulceroglandular tularemia in a toddler in Germany after a mosquito bite

  • Christof A Hanke
  • Joerg-Elard Otten
  • Reinhard Berner
  • Annerose Serr
  • Wolf Splettstoesser
  • Christian von Schnakenburg
Original Paper

DOI: 10.1007/s00431-008-0862-3

Cite this article as:
Hanke, C.A., Otten, J., Berner, R. et al. Eur J Pediatr (2009) 168: 937. doi:10.1007/s00431-008-0862-3

Abstract

Introduction

Although tularemia is a long-known disease, its significance had diminished over the last decades in Middle Europe. However, over the past years, there is new evidence suggesting that tularemia has re-emerged in Germany. In 2007, the highest number of human cases for almost 50 years has been notified. Beside typical vectors, new ways of transmission seem to gain significance. So far, mosquito bite-transmitted tularemia has only been known from Scandinavia but not from Middle Europe.

Case report

We report the first case of a 1-year-old toddler from Southwestern Germany with mosquito bite-associated ulceroglandular tularaemia. The new and interesting features of this case are the young age of the patient and the unusual transmission route. The available data suggesting changes in the epidemiology for tularemia in Germany are reviewed. This is an interesting case of infantile tularemia with a very unusual transmission route, highlighting ongoing changes in the epidemiology of tularemia in Germany.

Keywords

TularemiaInfantFrancisella tularensis holarcticaMosquito biteGermanyEpidemiology

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Christof A Hanke
    • 1
  • Joerg-Elard Otten
    • 2
  • Reinhard Berner
    • 1
  • Annerose Serr
    • 3
  • Wolf Splettstoesser
    • 4
  • Christian von Schnakenburg
    • 1
  1. 1.Department of Pediatrics and Adolescent MedicineUniversity Medical Center FreiburgFreiburgGermany
  2. 2.Department of Oral and Maxillofacial SurgeryUniversity Medical Center FreiburgFreiburgGermany
  3. 3.Institute of Microbiology, Division of VirologyUniversity Medical Center FreiburgFreiburgGermany
  4. 4.German Reference Laboratory for TularemiaBundeswehr Institute of MicrobiologyMunichGermany