{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:06:12Z","timestamp":1790409972283,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>In November 2018, a tularaemia outbreak occurred in Bavaria, Germany, among participants of a hare hunt and butchery employees handling the hares. We conducted an epidemiological outbreak investigation, including a retrospective cohort study among hunting participants, to identify likely transmission routes and activities associated with infection. Twelve of 41 participants were antibody\u2010positive for <jats:italic>Francisella (F.) tularensis<\/jats:italic> (attack rate: 29%). Cases reported influenza\u2010like symptoms (<jats:italic>n<\/jats:italic>\u00a0=\u00a011), lymphadenopathy (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) and conjunctivitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Infection only occurred in those hunting participants present while hares were processed, while risk of infection was highest when directly involved (RR\u00a0=\u00a010.0; 95%CI: 2.6\u2013392). <jats:italic>F.\u00a0tularensis<\/jats:italic> was isolated from 1\/4 hares. Only two individuals reported using some of the recommended personal protective equipment (PPE). Occurrence of mainly non\u2010specific symptoms, likely due to early treatment, was not indicative of a specific transmission route. Transmissions via direct (skin\/mucosa) contact and by inhalation of contaminated aerosols seem plausible. Promoting and increasing appropriate use of PPE among people processing hares is crucial to prevent future outbreaks.<\/jats:p>","DOI":"10.1111\/zph.12899","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T15:22:19Z","timestamp":1636989739000},"page":"106-116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological investigation of a tularaemia outbreak after a hare hunt in Bavaria, Germany, 2018"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-8092","authenticated-orcid":false,"given":"Stefanie","family":"B\u00f6hm","sequence":"first","affiliation":[{"name":"Bavarian Health and Food Safety Authority  Oberschleissheim Germany"},{"name":"Postgraduate Training for Applied Epidemiology (PAE) Robert Koch Institute  Berlin Germany"},{"name":"European Programme for Intervention Epidemiology Training (EPIET) European Centre for Disease Prevention and Control  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"vom Berge","sequence":"additional","affiliation":[{"name":"Local Health Authority Schwandorf  Schwandorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Hierhammer","sequence":"additional","affiliation":[{"name":"Local Health Authority Schwandorf  Schwandorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Jacob","sequence":"additional","affiliation":[{"name":"Consiliary Laboratory for Tularemia Robert Koch Institute  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Grunow","sequence":"additional","affiliation":[{"name":"Consiliary Laboratory for Tularemia Robert Koch Institute  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia M.","family":"Riehm","sequence":"additional","affiliation":[{"name":"Bavarian Health and Food Safety Authority  Oberschleissheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Konrad","sequence":"additional","affiliation":[{"name":"Bavarian Health and Food Safety Authority  Oberschleissheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Dauer","sequence":"additional","affiliation":[{"name":"Klinikum St. Marien  Amberg Germany"},{"name":"Department of Internal Medicine II University Hospital Saarland University  Saarbr\u00fccken Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Bouschery","sequence":"additional","affiliation":[{"name":"Klinikum St. Marien  Amberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Hossain","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine and Microbiology Klinikum St. Marien  Amberg Germany"},{"name":"Institute of Laboratory Medicine and Microbiology Kliniken Nordoberpfalz AG  Weiden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Schichtl","sequence":"additional","affiliation":[{"name":"Kleintierpraxis im Alten Forstamt  Pfreimd Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merle M.","family":"B\u00f6hmer","sequence":"additional","affiliation":[{"name":"Bavarian Health and Food Safety Authority  Oberschleissheim Germany"},{"name":"Institute of Social Medicine and Health Systems Research Otto\u2010von\u2010Guericke\u2010University  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Infectious disease epidemiological yearbook of notifiable diseases for 2018","author":"Heiden 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