Five Years of Surveillance for Tularemia Serovar B (Francisella tularensis holarctica) (Olsufjev) (Thiotrichales: Francisellaceae) Including Two Human Cases at an Endemic Site in San Mateo County, California

Tularemia is a highly infectious, potentially fatal disease of humans and animals caused by the gram negative, intracellular bacterium Francisella tularensis. The San Mateo County Mosquito and Vector Control District conducted surveillance for F. tularensis from 2017 to 2021 in Dermacentor occidentalis (Marx) (Ixodida: Ixodidae), D. variabilis (Say) (Ixodida: Ixodidae), and Haemaphysalis leporispalustris (Packard) (Ixodida: Ixodidae) ticks in coastal southwestern San Mateo County, California. A total of 3,021 D. occidentalis and 1,019 D. variabilis were collected. Of those, 25 positive pools of F. tularensis were detected (five ticks per pool, overall minimum infection prevalence: 0.62%). Twenty-two of the 25 positive pools (88%) contained D. occidentalis. Eighty-eight percent (88%) of all positive pools were collected from the western half of the site, nearest to the ocean. We did not detect a seasonal effect on the probability of detecting a positive tick pool. There were two human cases of tularemia during the summers of 2019 and 2021. We conducted rodent surveillance in June of 2019, before the human case report. Twenty-four small mammals were collected, but none of their sera tested positive for F. tularensis. It is clear that tularemia is endemic to this region of San Mateo County, but the extent of its range and its ecology is not currently well understood. Graphical Abstract