• 1.

    Penn RL. Francisella tularensis (Tularemia) In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier, 2005;26742685.

    • Search Google Scholar
    • Export Citation
  • 2.

    Petersen JM, Schriefer ME, Carter LG, et al. Laboratory analysis of tularemia in wild-trapped, commercially traded prairie dogs, Texas, 2002. Emerg Infect Dis 2004;10:419425.

    • Search Google Scholar
    • Export Citation
  • 3.

    Brown SL, McKinney FT & Klein GC, et al. Evaluation of a safranin-O-stained antigen microagglutination test for Francisella tularensis antibodies. J Clin Microbiol 1980;11:146148.

    • Search Google Scholar
    • Export Citation
  • 4.

    Feldman KA. Tularemia. J Am Vet Med Assoc 2003;222:725730.

  • 5.

    Tularemia—United States, 1990–2000. MMWR Morb Mortal Wkly Rep 2002;51:181184.

  • 6.

    Summary of notifiable diseases—United States, 2001. MMWR Morb Mortal Wkly Rep 2003;50:ixxiv, 1108.

  • 7.

    Hopkins RS, Jajosky RA & Hall PA, et al. Summary of notifiable diseases—United States, 2003. MMWR Morb Mortal Wkly Rep 2005;52:185.

  • 8.

    Feldman KA, Stiles-Enos D, Julian K, et al. Tularemia on Martha's Vineyard: seroprevalence and occupational risk. Emerg Infect Dis 2003;9:350354.

    • Search Google Scholar
    • Export Citation
  • 9.

    Groseclose SL, Brathwaite WS, Hall PA, et al. Summary of notifiable diseases—United States, 2002. MMWR Morb Mortal Wkly Rep 2004;51:184.

    • Search Google Scholar
    • Export Citation
  • 10.

    Farlow J, Wagner DM, Dukerich M, et al. Francisella tularensis in the United States. Emerg Infect Dis 2005;11:18351841.

  • 11.

    Bossi P, Tegnell A & Baka A, et al. Bichat guidelines for the clinical management of tularaemia and bioterrorism-related tularaemia. Euro Surveill 2004;9:E9E10.

    • Search Google Scholar
    • Export Citation
  • 12.

    Emmons RW, Woodie JD & Taylor MS, et al. Tularemia in a pet squirrel monkey (Saimiri sciureus). Lab Anim Care 1970;20:11491153.

  • 13.

    Doyle L, Markovits J & Anderson J, et al. Tularemia (Francisella tularensis) in a squirrel monkey (Saimiri scuireus). Lab Anim Sci 1988;38:491492.

    • Search Google Scholar
    • Export Citation
  • 14.

    Waggie KS, Day-Lollini PA, Murphy-Hackley PA, et al. Diagnostic exercise: illness, cutaneous hemorrhage, and death in two squirrel monkeys (Saimiri sciureus). Lab Anim Sci 1997;47:647649.

    • Search Google Scholar
    • Export Citation
  • 15.

    Meinkoth KR, Morton RJ, Meinkoth JH. Naturally occurring tularemia in a dog. J Am Vet Med Assoc 2004;225:545547.

  • 16.

    Rohrbach BW. Tularemia. J Am Vet Med Assoc 1988;193:428432.

  • 17.

    Posthaus H, Welle M & Morner T, et al. Tularemia in a common marmoset (Callithrix jacchus) diagnosed by 16S rRNA sequencing. Vet Microbiol 1998;61:145150.

    • Search Google Scholar
    • Export Citation
  • 18.

    Calle P, Bowerman D, Pape WJ. Nonhuman primate tularemia (Francisella tularensis) epizootic in a zoological park. J Zoo Wildl Med 1993;24:459468.

    • Search Google Scholar
    • Export Citation
  • 19.

    Nayar GP, Crawshaw GJ, Neufeld JL. Tularemia in a group of nonhuman primates. J Am Vet Med Assoc 1979;175:962963.

  • 20.

    Feldman KA, Enscore RE & Lathrop SL, et al. An outbreak of primary pneumonic tularemia on Martha's Vineyard. N Engl J Med 2001;345:16011606.

    • Search Google Scholar
    • Export Citation
  • 21.

    Petersen JM, Schriefer ME. Tularemia: emergence/re-emergence. Vet Res 2005;36:455467.

Advertisement

Tularemia as a cause of fever in a squirrel monkey

Catherine S. Beckwith DVM, PhD, DACLAM1
View More View Less
  • 1 Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA 94305-5410.

Abstract

Case Description—A 3-year-old female squirrel monkey (Saimiri sciureus sciureus) was examined because of sudden onset of lethargy and fever.

Clinical Findings—On initial examination, the monkey was weak and febrile and had petechiae on both thoracic limbs. Following collection, blood samples were slow to clot. During the next week, the monkey developed anemia and thrombocytopenia; Francisella tularensis was isolated from blood samples.

Treatment and Outcome—Treatment with gentamicin resulted in the monkey's gradual return to health, but inguinal lymphadenopathy developed after drug administration was discontinued. Francisella tularensis was isolated from a fine-needle aspirate of an enlarged lymph node. Treatment with streptomycin resulted in resolution of infection. By use of biochemical and molecular tests, the microbial isolate was characterized as F tularensis subsp holarctica. Results of a microagglutination assay confirmed that the monkey had developed serum antibodies against F tularensis.

Clinical Relevance—With timely diagnosis, treatment of tularemia in the squirrel monkey was successful. Francisella tularensis is the cause of a highly infectious zoonotic disease, and infection with this microorganism is enzootic in wildlife throughout the Northern Hemisphere. Tularemia should be considered in the differential diagnosis of febrile disease in animals of any species. Even limited or indirect exposure of humans or other animals to outdoor environments in which reservoir hosts and arthropod vectors are present can lead to transmission of F tularensis. Francisella tularensis is a class A agent of bioterrorism, and all cases of tularemia (regardless of species) should be reported to public health officials.

Abstract

Case Description—A 3-year-old female squirrel monkey (Saimiri sciureus sciureus) was examined because of sudden onset of lethargy and fever.

Clinical Findings—On initial examination, the monkey was weak and febrile and had petechiae on both thoracic limbs. Following collection, blood samples were slow to clot. During the next week, the monkey developed anemia and thrombocytopenia; Francisella tularensis was isolated from blood samples.

Treatment and Outcome—Treatment with gentamicin resulted in the monkey's gradual return to health, but inguinal lymphadenopathy developed after drug administration was discontinued. Francisella tularensis was isolated from a fine-needle aspirate of an enlarged lymph node. Treatment with streptomycin resulted in resolution of infection. By use of biochemical and molecular tests, the microbial isolate was characterized as F tularensis subsp holarctica. Results of a microagglutination assay confirmed that the monkey had developed serum antibodies against F tularensis.

Clinical Relevance—With timely diagnosis, treatment of tularemia in the squirrel monkey was successful. Francisella tularensis is the cause of a highly infectious zoonotic disease, and infection with this microorganism is enzootic in wildlife throughout the Northern Hemisphere. Tularemia should be considered in the differential diagnosis of febrile disease in animals of any species. Even limited or indirect exposure of humans or other animals to outdoor environments in which reservoir hosts and arthropod vectors are present can lead to transmission of F tularensis. Francisella tularensis is a class A agent of bioterrorism, and all cases of tularemia (regardless of species) should be reported to public health officials.

Contributor Notes

The author thanks Dr. Marty Schrieffer and Brook Yockey for providing reagents for and assisting with microagglutination, direct fluorescent, and PCR assays; Drs. David Fisher and Linda L. Werner for cytologic examinations; Dr. Corrine Davis for histologic evaluations; and Janis Atuk-Jones for graphics assistance.