Tularemia epidemic in northwestern Spain: clinical description and therapeutic response

This study describes the clinical characteristics of tularemia in Spain’s first epidemic outbreak and the therapeutic re-sponse and compares the efficacy of 3 antibiotics (strepto-mycin, ciprofloxacin, and doxycycline). For 142 cases of tu-laremia, the therapeutic failure rate was 22.5%; ciprofloxacin was the antibiotic with the lowest percentage of therapeutic failures and with the fewest side effects. Tularemia is a zoonosis caused by Francisella tularensis, a small gram-negative coccobacillus that is highly infective. The prin-cipal vectors are ticks and wild rabbits, and the natural hosts are lagomorphs and other rodents. The 2 principal biogroups are Francisella tularensis biovar tularensis (type A) and Fran-cisella tularensis biovar palaearctica (type B) [1]. Here, the clin-ical characteristics of 142 patients from the area of Tierra de Campos (Valladolid, northwestern Spain) diagnosed with tu