Schmid G P, Kornblatt A N, Connors C A, Patton C, Carney J, Hobbs J, Kaufmann A F
J Infect Dis. 1983 Jul;148(1):63-7. doi: 10.1093/infdis/148.1.63.
Between May 9 and July 3, 1979, 12 cases of glandular or ulceroglandular tularemia occurred in residents of the Crow Indian Reservation in southcentral Montana; only 13 cases had been reported from this geographic area in the preceding 25 years. The illness was mild, characterized by fever and cervical or occipital adenopathy. Systemic symptoms were self-limited although residual lymphadenopathy was common. Francisella tularensis was isolated from ticks (Dermacentor variabilis), the suspected vector. The strains of F tularensis did not ferment glycerol and thus were identified as type B rather than the more virulent type A. None of 83 adults hospitalized in an urban area 50 miles from the reservation had agglutination titers of antibody to F tularensis of greater than or equal to 1:40 compared with eight of 77 patients at the reservation hospital (P less than 0.01). Mild tularemia in reservation residents may have gone unrecognized; similar illness due to type B F tularensis may occur elsewhere.
1979年5月9日至7月3日期间，蒙大拿州中南部克劳印第安人保留地的居民中出现了12例腺型或溃疡腺型兔热病；在过去25年里，该地理区域仅报告过13例病例。病情较轻，以发热和颈部或枕部淋巴结病为特征。全身症状为自限性，不过残留淋巴结病很常见。从疑似传播媒介蜱虫（变异革蜱）中分离出了土拉弗朗西斯菌。土拉弗朗西斯菌菌株不发酵甘油，因此被鉴定为B型而非毒性更强的A型。与保留地医院77名患者中的8人相比，在距保留地50英里的市区住院的83名成年人中，无人对土拉弗朗西斯菌的抗体凝集效价大于或等于1:40（P<0.01）。保留地居民中的轻症兔热病可能未被识别；其他地方可能也会出现由B型土拉弗朗西斯菌引起的类似疾病。
