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Diagnostic tests included<jats:italic>Francisella tularensis<\/jats:italic>serology (including tube agglutination test and ELISA), PCR, and culture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 11 examined case-patients, the tularemia tube agglutination test was positive in ten and borderline in one. PCR detected the<jats:italic>F. tularensis<\/jats:italic><jats:italic>ISFtu2<\/jats:italic>elements and<jats:italic>fopA<\/jats:italic>gene in one rodent and a spring water sample from the same geographic area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the clinical manifestations of the disease suggesting an oropharyngeal form of tularemia, serology results in case patients, and<jats:italic>F. tularensis<\/jats:italic>detection in the local fauna and aquatic environment, the water supply of the village was the likely source of the tularemia outbreak. Intervention such as dredging and chlorination of the main water storage tank of the village and training of villagers and health care workers in preventive measures and treatment of the illness helped control the infection.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12879-021-06004-y","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T11:03:02Z","timestamp":1617188582000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Francisella tularensis human infections in a village of northwest Iran"],"prefix":"10.1186","volume":"21","author":[{"given":"Saber","family":"Esmaeili","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahdi","family":"Rohani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Ghasemi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Mehdi","family":"Gouya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simin","family":"Khayatzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Mahmoudi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein","family":"Ahangari Cohan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Maurin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan","family":"Mostafavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"issue":"1","key":"6004_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1196\/annals.1409.009","volume":"1105","author":"A Sj\u00f6stedt","year":"2007","unstructured":"Sj\u00f6stedt A. 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All protocols of this study were approved by Medical Ethics Committee of Pasteur Institute of Iran. The informed consent and signature of the informed consent were completed by adult participants and parents or legal guardians of minors. Consent from participants were obtained for publishing of all forms of personally identifiable data including biomedical, clinical, identifying information\/images and biometric data. All experiments were performed in accordance with relevant guidelines and regulations. Also, all animals\u2019 experiments were carried out in compliance with the ARRIVE guidelines. All stages of this study have been under the constant supervision of the Medical Ethics Committee of Pasteur Institute of Iran.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent from all participants were obtained for publishing of all forms of personally identifiable data including biomedical, clinical, identifying information\/images and biometric data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No conflict of interest is declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"310"}}