Waterborne outbreak of tularemia associated with crayfish fishing

In 1997, an outbreak of human tularemia associated with hare-hunting in central Spain affected 585 patients. We describe the identification of Francisella tularensis biovar palaearctica in a second outbreak of ulceroglandular tularemia associated with crayfish (Procambarus clarkii) fishing in a contaminated freshwater stream distant from the hare-associated outbreak. The second outbreak occurred 1 year after the first.This work was partially financed by Fondo de Investigación Sanitaria (FIS) 98/026-01 and NATO CRG 950380. Raquel Escudero was financied by a fellowship from the Fondo de Investigación Sanitaria. Ricela Sellek was financied by a "Beca de Iniciación" of the Instituto de Salud Carlos III.S