In Sweden, mosquitoes are considered the major vectors of the bacterium Francisella tularensis subsp. holarctica, which causes tularaemia. The aim of this study was to investigate whether mosquitoes acquire the bacterium as aquatic larvae and transmit the disease as adults. Mosquitoes sampled in a Swedish area where tularaemia is endemic (Örebro) were positive for the presence of F. tularensis deoxyribonucleic acid throughout the summer. Presence of the clinically relevant F. tularensis subsp. holarctica was confirmed in 11 out of the 14 mosquito species sampled. Experiments performed using laboratory-reared Aedes aegypti confirmed that F. tularensis subsp. holarctica was transstadially maintained from orally infected larvae to adult mosquitoes and that 25 % of the adults exposed as larvae were positive for the presence of F. tularensis-specific sequences for at least 2 weeks. In addition, we found that F. tularensis subsp. holarctica was transmitted to 58 % of the adult mosquitoes feeding on diseased mice. In a small-scale in vivo transmission experiment with F. tularensis subsp. holarctica-positive adult mosquitoes and susceptible mice, none of the animals developed tularaemia. However, we confirmed that there was transmission of the bacterium to blood vials by mosquitoes that had been exposed to the bacterium in the larval stage. Taken together, these results provide evidence that mosquitoes play a role in disease transmission in part of Sweden where tularaemia recurs.

Previous studies have reported the increased sensitivity of PCR targeting AF146527 over that of PCR targeting the B1 gene for diagnosis of toxoplasmosis. The present study suggests that the AF146527 element was absent in 4.8% of human Toxoplasma gondii -positive samples tested. The data argue that the B1 gene may be the preferred diagnostic target.

mIn the case of a release of highly pathogenic bacteria (HPB), there is an urgent need for rapid, accurate, and reliable diagnostics. MALDI-TOF mass spectrometry is a rapid, accurate, and relatively inexpensive technique that is becoming increasingly important in microbiological diagnostics to complement classical microbiology, PCR, and genotyping of HPB. In the present study, the results of a joint exercise with 11 partner institutions from nine European countries are presented. In this exercise, 10 distinct microbial samples, among them five HPB, Bacillus anthracis, Brucella canis, Burkholderia mallei, Burkholderia pseudomallei, and Yersinia pestis, were characterized under blinded conditions. Microbial strains were inactivated by high-dose gamma irradiation before shipment. Preparatory investigations ensured that this type of inactivation induced only subtle spectral changes with negligible influence on the quality of the diagnosis. Furthermore, pilot tests on nonpathogenic strains were systematically conducted to ensure the suitability of sample preparation and to optimize and standardize the workflow for microbial identification. The analysis of the microbial mass spectra was carried out by the individual laboratories on the basis of spectral libraries available on site. All mass spectra were also tested against an in-house HPB library at the Robert Koch Institute (RKI). The averaged identification accuracy was 77% in the first case and improved to >93% when the spectral diagnoses were obtained on the basis of the RKI library. The compilation of complete and comprehensive databases with spectra from a broad strain collection is therefore considered of paramount importance for accurate microbial identification. Highly pathogenic bacteria (HPB) are risk group 3 bacteria, which are defined as biological agents that can cause severe human disease and present a serious hazard to health care workers. This may present a risk of spreading to the community, but there is usually effective prophylaxis or treatment available (1). To this group belong bacteria such as Bacillus anthracis, Francisella tularensis subsp. tularensis (type A), Yersinia pestis, species of the Brucella melitensis group, Burkholderia mallei, and Burkholderia pseudomallei. HPB have the potential to be used in bioterrorist attacks (2, 3). The Centers for Disease Control and Prevention (CDC, Atlanta, GA) have classified B. anthracis, F. tularensis, and Y. pestis as category A and Brucella species, B. mallei, B. pseudomallei, and Coxiella burnetii as category B, comprising the main pathogens of concern for use in bioterrorist attacks (4). These pathogens may cause anthrax, tularemia, plague, brucellosis, glanders, melioidosis, and Q fever, respectively. In most parts of the world, the natural prevalence of these agents is low, even though some of these agents cause outbreaks in human and animal populations from time to time (5-8). The intentional release of these agents, however, can result in severe public health consequences, as was shown in the U...

It is critical to avoid delays in detecting strain manipulations, such as the addition/deletion of a gene or modification of genes for increased virulence or antibiotic resistance, using genome analysis during an epidemic outbreak or a bioterrorist attack. Our objective was to evaluate the efficiency of genome analysis in such an emergency context by using contigs produced by pyrosequencing without time-consuming finishing processes and comparing them to available genomes for the same species. For this purpose, we analyzed a clinical isolate of Francisella tularensis subspecies holarctica (strain URFT1), a potential biological weapon, and compared the data obtained with available genomic sequences of other strains. The technique provided 1,800,530 bp of assembled sequences, resulting in 480 contigs. We found by comparative analysis with other strains that all the gaps but one in the genome sequence were caused by repeats. No new genes were found, but a deletion was detected that included three putative genes and part of a fourth gene. The set of 35 candidate LVS virulence attenuation genes was identified, as well as a DNA gyrase mutation associated with quinolone resistance. Selection for variable sequences in URFT1 allowed the design of a strain-specific, highly effective typing system that was applied to 74 strains and six clinical specimens. The analysis presented herein may be completed within approximately 6 wk, a duration compatible with that required by an urgent context. In the bioterrorism context, it allows the rapid detection of strain manipulation, including intentionally added virulence genes and genes that support antibiotic resistance.[Supplemental material is available online at www.genome.org.]The availability of whole-genome sequences is revolutionizing the fields of bacteriology and infectious disease. By mid-2007, 479 bacterial genomes from 352 distinct species had been sequenced, including representative strains of all notable human pathogens (Fournier et al. 2007). With the increasing capacity of nucleotide sequencing over the last decade, complete bacterial pathogen genome sequencing has allowed, from the description of a unique bacterial genome, the understanding of genome organization and metabolic pathway analysis, and has facilitated the comparison of multiple strains to identify determinants responsible for strain-specific pathogenicity (Beres et al. 2006;Diep et al. 2006). This approach may include hypervirulent or multiresistant strains that eventually may be used as bioweapons or that may cause epidemic outbreaks. From this perspective, the rapid identification of new genes, gene loss, or gene modifications that would explain new virulence or antibiotic resistance, and the identification of strain-specific sequences that would make it possible to trace epidemics, is critical. Such comparisons have been tentatively performed using microarray technology (Broekhuijsen et al. 2003); however, this technique is not well suited to the detection of small sequence variations and is unable t...