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| {{Tularemia}} | | {{Tularemia}} |
| {{CMG}} {{AE}} {{IMD}} | | {{CMG}} {{AE}} {{IMD}} |
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| | ==Overview== |
| | Tularemia may be classified according the original mode of [[transmission]]. The mode of [[transmission]] will ultimately dictate the resulting [[Symptoms and Signs|clinical manifestations]] associated with tularemia infections. There are five common forms of tularemia, they include ulceroglandular, [[Glandular|glandular,]] oculoglandular, oropharyngeal, and [[Pneumonic plague|pneumonic]].<ref name="Signs Sym">Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016 </ref> |
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| ==Classification== | | ==Classification== |
| | Tularemia clinically manifests in five common forms: |
| | *[[Ulceroglandular]] |
| | *[[Glandular]] |
| | *Oculoglandular |
| | *Oropharyngeal |
| | *[[Pneumonic plague|Pneumonic]]<ref name="Signs Sym">Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016 </ref> |
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| Shown below is a table that classifies ''Tularemia'' infection based on the specific rickettsia organism responsible for infection. The classification of the organism responsible for infection dictates the choice of antimicrobial therapy.
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| | The table below represents Tularemia clinical manifestations according to their distinct modes of transmission. |
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| {| style="font-size: 85%;" | | {| style="font-size: 85%;" |
| ! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}} | | ! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Clinical Manifestation}} |
| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Organism}} | | ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Mode of Transmission}} |
| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Vector}}
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| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Endemic Regions}}
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Tularemia]]''' <ref name="Tulameria CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Francisella Tularensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''D. Andersoni, D. Variabilis''
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| | style="background: #DCDCDC; padding: 5px;" | '''United States:'''
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| *Widespread throughout the region, including higher populations in the Southeast, South-central, and the West.
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Rocky Mountain Spotted Fever]]''' <ref name="RMSF CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" |''Rickettsia Rickettsii''
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| | style="background: #DCDCDC; padding: 5px;" |''Wood Tick (Dermacentor Variabilis), D. andersoni''
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| | style="background: #DCDCDC; padding: 5px;" |'''United States:'''
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| *Eastern Region
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| *Southwest Region
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Helvetica Spotted Fever]]'''<ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia Helvetica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes Ricinus (European)''
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| | style="background: #DCDCDC; padding: 5px;" |'''Europe:'''
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| *Sweden
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| *Switzerland
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| *France
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| *Laos
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Ehrlichiosis Anaplasmosis]]''' <ref name="Ehrlichiosis CDC”">Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Ehrlichia Chaffeensis, E. Equi''
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| | style="background: #DCDCDC; padding: 5px;" | ''Lone Star Tick (Amblyomma Americanum), Ixodes Scapularis''
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| | style="background: #DCDCDC; padding: 5px;" | '''United States:'''
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| *South Atlantic Regions
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| *South-central Regions
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Human neoehrlichiosis''' <ref name="Ehrlichiosis CDC”">Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Neoehrlichia mikurensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Lone Star Tick (''Amblyomma Americanum)'
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Europe
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| *Asia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Rickettsiosis''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia''
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| | style="background: #DCDCDC; padding: 5px;" | ''No specific species identified''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *South Africa
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| *Morocco
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| *Mediterranean
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''African tick-bite fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia africae''
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| | style="background: #DCDCDC; padding: 5px;" | ''Amblyomma, Dermacentor, and Rhipicephalus species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Africa:'''
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| *Sub-Saharan
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| *West Indies
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''[[Queensland tick typhus]]''' <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia austalis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Australia
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| *Tasmania
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| |- | | |- |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''[[Q-fever (Typhus-like infection)]]''' <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref> | | | style="background: #F5F5F5; padding: 5px; text-align: center;" | Ulceroglandular |
| | style="background: #DCDCDC; padding: 5px;" | ''Coxiella burnetii (mimics the mechanisms of Rickettsia) '' | | | style="background: #DCDCDC; padding: 5px;" |Transmitted by the bite of an infected tick or deer fly |
| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes holocyclus and Amblyomma triguttatum''
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| | style="background: #DCDCDC; padding: 5px;" |'''Australia'''
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| *Widespread throughout Australia
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| |- | | |- |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Mediterranean spotted fever (Boutonneuse fever)''' <ref name="MSF”">Oztoprak N, Celebi G, Aydemir H, et al. [Mediterranean spotted fever due to contact with dog-tick]. Mikrobiyol Bul. 2008;42(4):7016.http:// http://www.ncbi.nlm.nih.gov/pubmed/19149095 Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> | | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Glandular]] |
| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia conorii'' | | | style="background: #DCDCDC; padding: 5px;" | Transmitted by the bite of an infected tick or deer fly, however skin [[ulcer]] does not form. |
| | style="background: #DCDCDC; padding: 5px;" | ''Brown Dog Tick (Rhipicephalus sanguineus)''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern Europe
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| *Southern and Western Asia
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| *Africa
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| *India
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| |- | | |- |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Far Eastern spotted fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> | | | style="background: #F5F5F5; padding: 5px; text-align: center;" |Oculoglandular |
| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia heilong-jiangensis'' | | | style="background: #DCDCDC; padding: 5px;" | Transmitted through eye contact with infected animal meat. Either through rubbing of the eyes during the butchering process or fluid exposure. |
| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Far portions of Eastern Russia
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| *Northern portions of China
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| *Eastern Asia
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| |- | | |- |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Aneruptive fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="Aneruptive Fever”">Fournier PE, Allombert C, Supputamongkol Y, Caruso G, Brouqui P, Raoult D. Aneruptive fever associated with antibodies to Rickettsia helvetica in Europe and Thailand. J Clin Microbiol. 2004;42(2):816-8. http://http://www.ncbi.nlm.nih.gov/pmc/articles/PMC344501/ Accessed on December 30, 2015</ref> | | | style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Pneumonic plague|Pneumonic]] |
| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia helvetica'' | | | style="background: #DCDCDC; padding: 5px;" | Most dangerous form of tularemia, commonly transmitted through inhalation of material infected with the organism. May also occur if a tularemia infection is left untreated and spreads through the blood streams to the lungs. |
| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:''' | |
| *Northern and Central portions of Europe
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| *Non-specific portions of Asia
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| |- | | |- |
| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Flinders Island spotted fever (Thai tick typhus)''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref> | | |}<ref name="Signs Sym">Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016 </ref> |
| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia honei''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |''' Widespread in Independent Regions'''
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| *Australia
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| *Thailand
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Japanese spotted fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia japonica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Japan'''
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| *Widespread yet isolated to portions of Japan
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Mediterranean spotted fever-like disease''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia massiliae and R. monacensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| ''R.massiliae induced:''
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| *France
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| *Greece
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| *Spain
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| *Portugal
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| *Switzerland
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| *Sicily
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| *Central Africa
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| *Mali
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| ''R.monacensis induced:''
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| *Europe
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| *North Africa
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Maculatum infection'''
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia parkeri''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Americas:'''
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| *United States
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| *Portions of Canada
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| *South America
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Tick-borne necrosis and lymphadenopathy''' <ref name="TNL”">Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease. Oteo JA, Ibarra V, Blanco JR, et al. Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease. Clin Microbiol Infect. 2004;10(4):327-31 http://www.ncbi.nlm.nih.gov/pubmed/15059122 Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia raoultii''
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| | style="background: #DCDCDC; padding: 5px;" | ''Dermacentor marginatus ''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Europe
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| *Asia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''North Asian Tick Typhus''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia sibirica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Russia
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| *China
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| *Mongolia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Lymphangitis''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia sibirica mogolotimonae''
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| | style="background: #DCDCDC; padding: 5px;" | 'No specific species identified
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern France
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| *Portugal
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| *China
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| *Africa
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''TIBOLA''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="TNL”">TIBOLA acquired in Southwest Germany. Rieg S, Schmoldt S, Theilacker C, et al. Tick borne lymphadenopathy (TIBOLA) acquired in Southwestern Germany. BMC Infect Dis. 2011;11:167. http://www.ncbi.nlm.nih.gov/pubmed/21663601 Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia slovaca''
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| | style="background: #DCDCDC; padding: 5px;" | ''Dermacentor species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern and Eastern Europe
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| *Asia
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| |}
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| ==References== | | ==References== |
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| [[Category:Zoonoses]] | | [[Category:Zoonoses]] |
| [[Category:Biological weapons]] | | [[Category:Biological weapons]] |
| [[Category:Infectious disease]]
| |