Lopes de Carvalho, I.Nascimento, P.Núncio, M.S.Rico, M.T.2019-02-182019-02-182018-11-19Front Public Health. 2018 Nov 19;6:325. doi: 10.3389/fpubh.2018.00325. eCollection 20182296-2565http://hdl.handle.net/10400.18/5844Case report articleFree PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252358/Tularemia is a zoonotic disease caused by Francisella tularensis, a gram-negative, facultative intracellular bacterium. Typically, human and animal infections are caused by F. tularensis subspecies tularensis (type A) strains mainly in Canada and USA, and F. tularensis subspecies holarctica (type B) strains throughout the northern hemisphere, including Europe. Tularemia is a disease with epidemiological surveillance in Europe since 2003 (Decision 2000/96/EC). Despite being considered an uncommon disease, recent outbreaks have been reported in several countries, including Spain, France, Scandinavia, Balkans and Hungary, and sporadic cases in Austria, Italy and the United Kingdom. In spite offbeing a disease of compulsory declaration in Portugal since 2003, until now no human cases were reported. In Portugal, seroprevalence rate of high-risk population is 8.9% and F. tularensis subsp. holarctica was first detected in 2007 by molecular methods in a human sample. Since 1998, National Institute of Health has provided the laboratory diagnosis of this disease, following the occurrence of an epidemic outbreak in Spain. The authors report here the first case of ulceroglandular form of tularemia in Portugal, probably of imported origin.engTularemiaPatientUlceroglandularFrancisella tularensis subsp. holarcticaCase ReportPortugalInfecções Sistémicas e Zoonosesjournal article10.3389/fpubh.2018.00325