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Case Reports in Infectious Diseases
Volume 2013 (2013), Article ID 916985, 3 pages
Case Report

Indigenous Infection with Francisella tularensis holarctica in The Netherlands

1Department of Medical Microbiology, Beatrix Hospital and Albert Schweitzer Hospital, P.O. Box 899, 3300 AW Dordrecht, The Netherlands
2Department of Surgery, Beatrix Hospital, P.O. Box 90, 4200 AB Gorinchem, The Netherlands
3Division for CBRN Defence and Security, FOI—Swedish Defence Research Agency, Umeå, Sweden
4Department of Earth, Environmental, and Life Sciences, TNO, P.O. Box 45, 2280 AA Rijswijk, The Netherlands
5Public Health Service Zuid-Holland Zuid, P.O. Box 166, 3300 AD Dordrecht, The Netherlands
6Diagnostic Laboratory for Infectious Diseases and Perinatal Screening (LIS), Center for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands

Received 9 June 2013; Accepted 1 August 2013

Academic Editors: C. L. Gibert, A. Marangoni, C. G. Meyer, and D. L. Palazzi

Copyright © 2013 Boulos Maraha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report here the first case of indigenous tularemia detected in The Netherlands, a nonendemic country, since 1953. Whole genome DNA sequence analysis assigned the isolate BD11-00177 to the genomic group B.FTNF002-00, which previously has been exclusively reported from Spain, France, Italy, Switzerland, and Germany. The patient had not been abroad for years, which implies that this is an indigenous infection. The current case might predict an upcoming distribution of Francisella tularensis holarctica genomic group B.FTNF002-00 in Europe.