Francisella tularensis: background document for the WHO guidelines for drinking-water quality
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World Health Organization
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ii, 8 p.
This background document supports the WHO Guidelines for drinking-water quality by reviewing the public health significance of Francisella tularensis, the causative agent of tularaemia, in relation to drinking-water supplies. The publication summarizes current evidence on the microbiology, epidemiology, transmission routes, environmental occurrence and clinical manifestations of F. tularensis, with particular attention to documented waterborne outbreaks. The document describes the different subspecies of the bacterium, their geographic distribution and virulence, and outlines the main routes of human exposure, including contaminated drinking-water, direct contact with infected animals, insect bites and inhalation of contaminated aerosols. The document highlights that multiple outbreaks of waterborne tularaemia have been associated with untreated or inadequately treated drinking-water contaminated by animal carcasses or excreta, particularly from rodents, rabbits and hares. It reviews available detection methods and evidence on the persistence of F. tularensis in water, soil, biofilms and amoebae. The publication also discusses prevention and management measures within water safety plans, including source water protection, adequate treatment and disinfection, distribution system protection and biofilm control to reduce risks associated with drinking-water contamination.
This background document supports the WHO Guidelines for drinking-water quality by reviewing the public health significance of Francisella tularensis, the causative agent of tularaemia, in relation to drinking-water supplies. The publication summarizes current evidence on the microbiology, epidemiology, transmission routes, environmental occurrence and clinical manifestations of F. tularensis, with particular attention to documented waterborne outbreaks. The document describes the different subspecies of the bacterium, their geographic distribution and virulence, and outlines the main routes of human exposure, including contaminated drinking-water, direct contact with infected animals, insect bites and inhalation of contaminated aerosols. The document highlights that multiple outbreaks of waterborne tularaemia have been associated with untreated or inadequately treated drinking-water contaminated by animal carcasses or excreta, particularly from rodents, rabbits and hares. It reviews available detection methods and evidence on the persistence of F. tularensis in water, soil, biofilms and amoebae. The publication also discusses prevention and management measures within water safety plans, including source water protection, adequate treatment and disinfection, distribution system protection and biofilm control to reduce risks associated with drinking-water contamination.