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Previous Volume 346:1027-1029 March 28, 2002 Number 13 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: We disagree with Feldman et al. and Hornick (Nov. 29 issue)^1,2 about establishing a diagnosis of primary pneumonic tularemia on the basis of clinical symptoms and a single high titer of anti–Francisella tularensis antibody alone, even during an outbreak of tularemia. A single high titer may reflect a previous infection with F. tularensis, either symptomatic or asymptomatic. High titers of both IgG and IgM antibodies, determined by agglutination assay or enzyme-linked immunosorbent assay, can persist for more than 10 years.³ Asymptomatic infection is not uncommon.⁴ Unlike the ulceroglandular form of tularemia, the pneumonic form has no . . . [Full Text of this Article]

References

This article has been cited by other articles:

• Eliasson, H., Olcen, P., Sjostedt, A., Jurstrand, M., Back, E., Andersson, S. (2008). Kinetics of the Immune Response Associated with Tularemia: Comparison of an Enzyme-Linked Immunosorbent Assay, a Tube Agglutination Test, and a Novel Whole-Blood Lymphocyte Stimulation Test. CVI 15: 1238-1243 [Abstract] [Full Text]  
• Goethert, H. K., Shani, I., Telford, S. R. III (2004). Genotypic Diversity of Francisella tularensis Infecting Dermacentor variabilis Ticks on Martha's Vineyard, Massachusetts. J. Clin. Microbiol. 42: 4968-4973 [Abstract] [Full Text]