Tularemia VirCLia® IgG + IgM monotest

Tularaemia is a zoonotic infection caused by Francisella tularensis. F. tularensis is considered to have four subspecies, of which the tularensis subspecies or type A, predominantly present in North America, is the most virulent subspecies in both animals and humans. Type B is found in Europe and Asia and causes a less virulent form of the disease. The bacterium circulates in populations of rodents and lagomorphs, and outbreaks in humans often parallel outbreaks in animal populations. The incubation period is 3–5 days normally (range 1–21 days). Most cases of naturally occurring tularemia are ulceroglandular disease, involving an ulcer at the inoculation site and regional lymphadenopathy. Lymphadenopathy can take a significant period to resolve, even with treatment. Other presentations (oculoglandular and oropharyngeal disease) may occur. Occasionally patients with tularemia present with a nonspecific febrile systemic illness (typhoidal tularemia) without evidence of a primary inoculation site. Pulmonary disease can occur naturally (pneumonic tularemia), but is uncommon. Tularemia can be transmitted by direct contact with infected animals or their tissues, ingestion of undercooked infected meat or contaminated water, animal bites or scratches, arthropod bites, and inhalation of an aerosol or contaminated dust. Tularaemia responds well to antibiotic therapy and the mortality rate of the more acute forms of the disease is reduced significantly if the patient receives suitable antibiotics. The diagnosis of tularemia by culture can be challenging because the organism grows poorly on routine culture medium. The low sensitivity of culture methods together with the lack of standardization in PCR methodology for the direct identification of the pathogen make serological assay the most widely used tool for the diagnosis of tularemia. Levels of antibody may be measurable within 1 week after infection, although significant levels usually appear in 2 weeks. Antibody levels against F. tularensis can remain detectable for years. Detection methods based on chemiluminescence have received much attention due to their low background, linearity and wide dynamic range. When coupled to enzyme immunoassays, the signal amplification effect provided by the enzyme enables the design of CLIA (ChemiLuminescent ImmunoAssay) tests with shorter incubation times while keeping or improving their sensitivity.