This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (397)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in JAMA  Topic Collections  • Bacterial Infections  • Bioterrorism  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Medical and Public Health Management

David T. Dennis, MD, MPH; Thomas V. Inglesby, MD; Donald A. Henderson, MD, MPH; John G. Bartlett, MD; Michael S. Ascher, MD; Edward Eitzen, MD, MPH; Anne D. Fine, MD; Arthur M. Friedlander, MD; Jerome Hauer, MHS; Marcelle Layton, MD; Scott R. Lillibridge, MD; Joseph E. McDade, PhD; Michael T. Osterholm, PhD, MPH; Tara O'Toole, MD, MPH; Gerald Parker, PhD, DVM; Trish M. Perl, MD, MSc; Philip K. Russell, MD; Kevin Tonat, DrPH, MPH; for the Working Group on Civilian Biodefense

JAMA. 2001;285:2763-2773.

Objective  The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if tularemia is used as a biological weapon against a civilian population.

Participants  The working group included 25 representatives from academic medical centers, civilian and military governmental agencies, and other public health and emergency management institutions and agencies.

Evidence  MEDLINE databases were searched from January 1966 to October 2000, using the Medical Subject Headings Francisella tularensis, Pasteurella tularensis, biological weapon, biological terrorism, bioterrorism, biological warfare, and biowarfare. Review of these references led to identification of relevant materials published prior to 1966. In addition, participants identified other references and sources.

Consensus Process  Three formal drafts of the statement that synthesized information obtained in the formal evidence-gathering process were reviewed by members of the working group. Consensus was achieved on the final draft.

Conclusions  A weapon using airborne tularemia would likely result 3 to 5 days later in an outbreak of acute, undifferentiated febrile illness with incipient pneumonia, pleuritis, and hilar lymphadenopathy. Specific epidemiological, clinical, and microbiological findings should lead to early suspicion of intentional tularemia in an alert health system; laboratory confirmation of agent could be delayed. Without treatment, the clinical course could progress to respiratory failure, shock, and death. Prompt treatment with streptomycin, gentamicin, doxycycline, or ciprofloxacin is recommended. Prophylactic use of doxycycline or ciprofloxacin may be useful in the early postexposure period.

Author Affiliations: National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Dennis, Lillibridge, and McDade); Center for Civilian Biodefense Studies, Johns Hopkins University Schools of Medicine (Drs Inglesby, Bartlett, and Perl) and Public Health (Drs Henderson, O'Toole, and Russell), Baltimore, Md; Viral and Rickettsial Diseases Laboratory, California Department of Health Services, Berkeley (Dr Ascher); US Army Medical Research Institute of Infectious Diseases, Ft Detrick, Md (Drs Eitzen, Friedlander, and Parker); Bureau of Communicable Disease, New York City Health Department (Drs Fine and Layton), and Kroll Associates (Mr Hauer), New York, NY; ican Inc, Eden Prairie, Minn (Dr Osterholm); and Office of Emergency Preparedness, Department of Health and Human Services, Rockville, Md (Dr Tonat).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Citation of Unethical Research
Martin Furmanski, David T. Dennis, Thomas V. Inglesby, Tara O'Toole, and Donald A. Henderson
JAMA. 2002;287(4):452-453.
EXTRACT | FULL TEXT  

RELATED ARTICLE

June 6, 2001
JAMA. 2001;285(21):2793-2794.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Global Transcriptional Response to Spermine, a Component of the Intramacrophage Environment, Reveals Regulation of Francisella Gene Expression through Insertion Sequence Elements
Carlson et al.
J. Bacteriol. 2009;191:6855-6864.
ABSTRACT | FULL TEXT  

Substituted diphenyl ethers as a broad-spectrum platform for the development of chemotherapeutics for the treatment of tularaemia
England et al.
J Antimicrob Chemother 2009;64:1052-1061.
ABSTRACT | FULL TEXT  

Francisella tularensis Induces Ubiquitin-Dependent Major Histocompatibility Complex Class II Degradation in Activated Macrophages
Wilson et al.
Infect. Immun. 2009;77:4953-4965.
ABSTRACT | FULL TEXT  

Vaccination with an Attenuated Strain of Francisella novicida Prevents T-Cell Depletion and Protects Mice Infected with the Wild-Type Strain from Severe Sepsis
Sharma et al.
Infect. Immun. 2009;77:4314-4326.
ABSTRACT | FULL TEXT  

The Case for Developing Consensus Standards for Research in Microbial Pathogenesis: Bacillus anthracis Toxins as an Example
Hughes et al.
Infect. Immun. 2009;77:4182-4186.
FULL TEXT  

Lethal pulmonary infection with Francisella novicida is associated with severe sepsis
Sharma et al.
J. Leukoc. Biol. 2009;86:491-504.
ABSTRACT | FULL TEXT  

Reintroduction of Two Deleted Virulence Loci Restores Full Virulence to the Live Vaccine Strain of Francisella tularensis
Salomonsson et al.
Infect. Immun. 2009;77:3424-3431.
ABSTRACT | FULL TEXT  

Functional analyses of pilin-like proteins from Francisella tularensis: complementation of type IV pilus phenotypes in Neisseria gonorrhoeae
Salomonsson et al.
Microbiology 2009;155:2546-2559.
ABSTRACT | FULL TEXT  

Pharmacological Exploitation of an Off-Target Antibacterial Effect of the Cyclooxygenase-2 Inhibitor Celecoxib against Francisella tularensis
Chiu et al.
Antimicrob. Agents Chemother. 2009;53:2998-3002.
ABSTRACT | FULL TEXT  

Pathology of Inhalational Francisella tularensis spp. tularensis SCHU S4 Infection in African Green Monkeys (Chlorocebus aethiops)
Twenhafel et al.
Vet Pathol 2009;46:698-706.
ABSTRACT | FULL TEXT  

Generalized tularemia in a vervet monkey (Chlorocebus aethiops) and a patas monkey (Erythrocebus patas) in a zoo
Gyuranecz et al.
jvdi 2009;21:384-387.
ABSTRACT | FULL TEXT  

T Cells from Lungs and Livers of Francisella tularensis-Immune Mice Control the Growth of Intracellular Bacteria
Collazo et al.
Infect. Immun. 2009;77:2010-2021.
ABSTRACT | FULL TEXT  

Differential Requirements for Protection against Mucosal Challenge with Francisella tularensis in the Presence versus Absence of Cholera Toxin B and Inactivated F. tularensis
Bitsaktsis et al.
J. Immunol. 2009;182:4899-4909.
ABSTRACT | FULL TEXT  

Single-copy chromosomal integration systems for Francisella tularensis
LoVullo et al.
Microbiology 2009;155:1152-1163.
ABSTRACT | FULL TEXT  

Tularemic Meningitis in the United States
Hofinger et al.
Arch Neurol 2009;66:523-527.
ABSTRACT | FULL TEXT  

Antigen-specific B-1a antibodies induced by Francisella tularensis LPS provide long-term protection against F. tularensis LVS challenge
Cole et al.
Proc. Natl. Acad. Sci. USA 2009;106:4343-4348.
ABSTRACT | FULL TEXT  

Francisella tularensis Infection-Derived Monoclonal Antibodies Provide Detection, Protection, and Therapy
Savitt et al.
CVI 2009;16:414-422.
ABSTRACT | FULL TEXT  

Time Course of Hematogenous Dissemination of Francisella tularensis A1, A2, and Type B in Laboratory Mice
Eisen et al.
Am J Trop Med Hyg 2009;80:259-262.
ABSTRACT | FULL TEXT  

Francisella inhibits STAT1-mediated signaling in macrophages and prevents activation of antigen-specific T cells
Roth et al.
Int Immunol 2009;21:19-28.
ABSTRACT | FULL TEXT  

TLR4-mediated activation of dendritic cells by the heat shock protein DnaK from Francisella tularensis
Ashtekar et al.
J. Leukoc. Biol. 2008;84:1434-1446.
ABSTRACT | FULL TEXT  

RipA, a Cytoplasmic Membrane Protein Conserved among Francisella Species, Is Required for Intracellular Survival
Fuller et al.
Infect. Immun. 2008;76:4934-4943.
ABSTRACT | FULL TEXT  

Evasion of Complement-Mediated Lysis and Complement C3 Deposition Are Regulated by Francisella tularensis Lipopolysaccharide O Antigen
Clay et al.
J. Immunol. 2008;181:5568-5578.
ABSTRACT | FULL TEXT  

Francisella tularensis Live Vaccine Strain Induces Macrophage Alternative Activation as a Survival Mechanism
Shirey et al.
J. Immunol. 2008;181:4159-4167.
ABSTRACT | FULL TEXT  

Diverse Myeloid and Lymphoid Cell Subpopulations Produce Gamma Interferon during Early Innate Immune Responses to Francisella tularensis Live Vaccine Strain
De Pascalis et al.
Infect. Immun. 2008;76:4311-4321.
ABSTRACT | FULL TEXT  

Molecular Method for Discrimination between Francisella tularensis and Francisella-Like Endosymbionts
Escudero et al.
J. Clin. Microbiol. 2008;46:3139-3143.
ABSTRACT | FULL TEXT  

Combined Deletion of Four Francisella novicida Acid Phosphatases Attenuates Virulence and Macrophage Vacuolar Escape
Mohapatra et al.
Infect. Immun. 2008;76:3690-3699.
ABSTRACT | FULL TEXT  

Francisella tularensis: unravelling the secrets of an intracellular pathogen
Oyston
J Med Microbiol 2008;57:921-930.
ABSTRACT | FULL TEXT  

Mast cells inhibit intramacrophage Francisella tularensis replication via contact and secreted products including IL-4
Ketavarapu et al.
Proc. Natl. Acad. Sci. USA 2008;105:9313-9318.
ABSTRACT | FULL TEXT  

Characterization of the Francisella tularensis subsp. novicida type IV pilus
Zogaj et al.
Microbiology 2008;154:2139-2150.
ABSTRACT | FULL TEXT  

Initial Delay in the Immune Response to Francisella tularensis Is Followed by Hypercytokinemia Characteristic of Severe Sepsis and Correlating with Upregulation and Release of Damage-Associated Molecular Patterns
Mares et al.
Infect. Immun. 2008;76:3001-3010.
ABSTRACT | FULL TEXT  

Type IV Pili in Francisella tularensis: Roles of pilF and pilT in Fiber Assembly, Host Cell Adherence, and Virulence
Chakraborty et al.
Infect. Immun. 2008;76:2852-2861.
ABSTRACT | FULL TEXT  

Francisella tularensis Invasion of Lung Epithelial Cells
Craven et al.
Infect. Immun. 2008;76:2833-2842.
ABSTRACT | FULL TEXT  

Subversion of complement activation at the bacterial surface promotes serum resistance and opsonophagocytosis of Francisella tularensis
Ben Nasr and Klimpel
J. Leukoc. Biol. 2008;84:77-85.
ABSTRACT | FULL TEXT  

Francisella Targets Cholesterol-Rich Host Cell Membrane Domains for Entry into Macrophages
Tamilselvam and Daefler
J. Immunol. 2008;180:8262-8271.
ABSTRACT | FULL TEXT  

Unexplained Deaths in Connecticut, 2002-2003:Failure to Consider Category A Bioterrorism Agents in Differential Diagnoses
Palumbo et al.
dmphp 2008;2:87-94.
ABSTRACT | FULL TEXT  

Respiratory Francisella tularensis Live Vaccine Strain Infection Induces Th17 Cells and Prostaglandin E2, Which Inhibits Generation of Gamma Interferon-Positive T Cells
Woolard et al.
Infect. Immun. 2008;76:2651-2659.
ABSTRACT | FULL TEXT  

In Vitro Susceptibility of Isolates of Francisella tularensis Types A and B from North America
Urich and Petersen
Antimicrob. Agents Chemother. 2008;52:2276-2278.
ABSTRACT | FULL TEXT  

Macrophage Proinflammatory Response to Francisella tularensis Live Vaccine Strain Requires Coordination of Multiple Signaling Pathways
Cole et al.
J. Immunol. 2008;180:6885-6891.
ABSTRACT | FULL TEXT  

Rapid comparative genomic analysis for clinical microbiology: The Francisella tularensis paradigm
La Scola et al.
Genome Res 2008;18:742-750.
ABSTRACT | FULL TEXT  

Genomic Markers for Differentiation of Francisella tularensis subsp. tularensis A.I and A.II Strains
Molins-Schneekloth et al.
Appl. Environ. Microbiol. 2008;74:336-341.
ABSTRACT | FULL TEXT  

Differential Requirements by CD4+ and CD8+ T Cells for Soluble and Membrane TNF in Control of Francisella tularensis Live Vaccine Strain Intramacrophage Growth
Cowley et al.
J. Immunol. 2007;179:7709-7719.
ABSTRACT | FULL TEXT  

Identification of LpxL, a Late Acyltransferase of Francisella tularensis
McLendon et al.
Infect. Immun. 2007;75:5518-5531.
ABSTRACT | FULL TEXT  

Differential effects of Francisella tularensis lipopolysaccharide on B lymphocytes
Rahhal et al.
J. Leukoc. Biol. 2007;82:813-820.
ABSTRACT | FULL TEXT  

Attenuation and protective efficacy of an O-antigen-deficient mutant of Francisella tularensis LVS
Li et al.
Microbiology 2007;153:3141-3153.
ABSTRACT | FULL TEXT  

Diagnostic approaches for oculoglandular tularemia: advantages of PCR
Kantardjiev et al.
Br J Ophthalmol 2007;91:1206-1208.
ABSTRACT | FULL TEXT  

Role of Primary Human Alveolar Epithelial Cells in Host Defense against Francisella tularensis Infection
Gentry et al.
Infect. Immun. 2007;75:3969-3978.
ABSTRACT | FULL TEXT  

Toll-Like Receptor 2-Mediated Signaling Requirements for Francisella tularensis Live Vaccine Strain Infection of Murine Macrophages
Cole et al.
Infect. Immun. 2007;75:4127-4137.
ABSTRACT | FULL TEXT  

From protein microarrays to diagnostic antigen discovery: a study of the pathogen Francisella tularensis
Sundaresh et al.
Bioinformatics 2007;23:i508-i518.
ABSTRACT | FULL TEXT  

Genome-Wide Identification of Francisella tularensis Virulence Determinants
Su et al.
Infect. Immun. 2007;75:3089-3101.
ABSTRACT | FULL TEXT  

A Defined O-Antigen Polysaccharide Mutant of Francisella tularensis Live Vaccine Strain Has Attenuated Virulence while Retaining Its Protective Capacity
Sebastian et al.
Infect. Immun. 2007;75:2591-2602.
ABSTRACT | FULL TEXT  

Mouse Model of Oral Infection with Virulent Type A Francisella tularensis
KuoLee et al.
Infect. Immun. 2007;75:1651-1660.
ABSTRACT | FULL TEXT  

Task Force IV: Cardiovascular Effects of Emerging Infectious Diseases and Biological Terrorism Threats: Basic, Clinical, and Population Science Research and Training Needs
Madjid et al.
J Am Coll Cardiol 2007;49:1407-1412.
FULL TEXT  

Francisella tularensis-Infected Macrophages Release Prostaglandin E2 that Blocks T Cell Proliferation and Promotes a Th2-Like Response
Woolard et al.
J. Immunol. 2007;178:2065-2074.
ABSTRACT | FULL TEXT  

Francisella tularensis Replicates within Alveolar Type II Epithelial Cells In Vitro and In Vivo following Inhalation
Hall et al.
Infect. Immun. 2007;75:1034-1039.
ABSTRACT | FULL TEXT  

Characterization of Francisella tularensis Outer Membrane Proteins
Huntley et al.
J. Bacteriol. 2007;189:561-574.
ABSTRACT | FULL TEXT  

Identification of MglA-Regulated Genes Reveals Novel Virulence Factors in Francisella tularensis
Brotcke et al.
Infect. Immun. 2006;74:6642-6655.
ABSTRACT | FULL TEXT  

Mac-1+ Cells Are the Predominant Subset in the Early Hepatic Lesions of Mice Infected with Francisella tularensis
Rasmussen et al.
Infect. Immun. 2006;74:6590-6598.
ABSTRACT | FULL TEXT  

Potential Source of Francisella tularensis Live Vaccine Strain Attenuation Determined by Genome Comparison
Rohmer et al.
Infect. Immun. 2006;74:6895-6906.
ABSTRACT | FULL TEXT  

Genetic tools for highly pathogenic Francisella tularensis subsp. tularensis.
LoVullo et al.
Microbiology 2006;152:3425-3435.
ABSTRACT | FULL TEXT  

Structure of Francisella tularensis AcpA: PROTOTYPE OF A UNIQUE SUPERFAMILY OF ACID PHOSPHATASES AND PHOSPHOLIPASES C
Felts et al.
J. Biol. Chem. 2006;281:30289-30298.
ABSTRACT | FULL TEXT  

Chromosome Rearrangement and Diversification of Francisella tularensis Revealed by the Type B (OSU18) Genome Sequence.
Petrosino et al.
J. Bacteriol. 2006;188:6977-6985.
ABSTRACT | FULL TEXT  

Critical role for serum opsonins and complement receptors CR3 (CD11b/CD18) and CR4 (CD11c/CD18) in phagocytosis of Francisella tularensis by human dendritic cells (DC): uptake of Francisella leads to activation of immature DC and intracellular survival of the bacteria
Ben Nasr et al.
J. Leukoc. Biol. 2006;80:774-786.
ABSTRACT | FULL TEXT  

Attenuated Francisella novicida Transposon Mutants Protect Mice against Wild-Type Challenge
Tempel et al.
Infect. Immun. 2006;74:5095-5105.
ABSTRACT | FULL TEXT  

Characterization of the Receptor-Ligand Pathways Important for Entry and Survival of Francisella tularensis in Human Macrophages
Balagopal et al.
Infect. Immun. 2006;74:5114-5125.
ABSTRACT | FULL TEXT  

Deletion of TolC orthologs in Francisella tularensis identifies roles in multidrug resistance and virulence
Gil et al.
Proc. Natl. Acad. Sci. USA 2006;103:12897-12902.
ABSTRACT | FULL TEXT  

Immunization to Protect the US Armed Forces: Heritage, Current Practice, and Prospects
Grabenstein et al.
Epidemiol Rev 2006;28:3-26.
ABSTRACT | FULL TEXT  

Population Structure of Francisella tularensis.
Nubel et al.
J. Bacteriol. 2006;188:5319-5324.
ABSTRACT | FULL TEXT  

Basis for the Failure of Francisella tularensis Lipopolysaccharide To Prime Human Polymorphonuclear Leukocytes.
Barker et al.
Infect. Immun. 2006;74:3277-3284.
ABSTRACT | FULL TEXT  

Characterization of the Siderophore of Francisella tularensis and Role of fslA in Siderophore Production
Sullivan et al.
J. Bacteriol. 2006;188:3785-3795.
ABSTRACT | FULL TEXT  

Immunologic Consequences of Francisella tularensis Live Vaccine Strain Infection: Role of the Innate Immune Response in Infection and Immunity.
Cole et al.
J. Immunol. 2006;176:6888-6899.
ABSTRACT | FULL TEXT  

Toll-Like Receptor 2 Is Required for Inflammatory Responses to Francisella tularensis LVS.
Katz et al.
Infect. Immun. 2006;74:2809-2816.
ABSTRACT | FULL TEXT  

Francisella tularensis LPS induces the production of cytokines in human monocytes and signals via Toll-like receptor 4 with much lower potency than E. coli LPS
Duenas et al.
Int Immunol 2006;18:785-795.
ABSTRACT | FULL TEXT  

Intranasal Vaccination with a Defined Attenuated Francisella novicida Strain Induces Gamma Interferon-Dependent Antibody-Mediated Protection against Tularemia
Pammit et al.
Infect. Immun. 2006;74:2063-2071.
ABSTRACT | FULL TEXT  

Transcriptional profiling of host responses in mouse lungs following aerosol infection with type A Francisella tularensis.
Andersson et al.
J Med Microbiol 2006;55:263-271.
ABSTRACT | FULL TEXT  

Tularemia and Once-Daily Gentamicin
Hassoun et al.
Antimicrob. Agents Chemother. 2006;50:824-824.
FULL TEXT  

Hawaii Veterinarians' Bioterrorism Preparedness Needs Assessment Survey
Katz et al.
jvme 2006;33:612-617.
ABSTRACT | FULL TEXT  

A Mutant of Francisella tularensis Strain SCHU S4 Lacking the Ability To Express a 58-Kilodalton Protein Is Attenuated for Virulence and Is an Effective Live Vaccine
Twine et al.
Infect. Immun. 2005;73:8345-8352.
ABSTRACT | FULL TEXT  

Discrimination between Francisella tularensis and Francisella-Like Endosymbionts when Screening Ticks by PCR
Kugeler et al.
Appl. Environ. Microbiol. 2005;71:7594-7597.
ABSTRACT | FULL TEXT  

Tularemia in Denmark: Identification of a Francisella tularensis subsp. holarctica Strain by Real-Time PCR and High-Resolution Typing by Multiple-Locus Variable-Number Tandem Repeat Analysis
Bystrom et al.
J. Clin. Microbiol. 2005;43:5355-5358.
ABSTRACT | FULL TEXT  

Detection of Diverse New Francisella-Like Bacteria in Environmental Samples
Barns et al.
Appl. Environ. Microbiol. 2005;71:5494-5500.
ABSTRACT | FULL TEXT  

Francisella tularensis Enters Macrophages via a Novel Process Involving Pseudopod Loops
Clemens et al.
Infect. Immun. 2005;73:5892-5902.
ABSTRACT | FULL TEXT  

CD4-CD8- T cells control intracellular bacterial infections both in vitro and in vivo
Cowley et al.
JEM 2005;202:309-319.
ABSTRACT | FULL TEXT  

Pharmacists in the Omaha Metropolitan Medical Response System
Massoomi
Am J Health Syst Pharm 2005;62:1290-1298.
ABSTRACT | FULL TEXT  

Evolution of Subspecies of Francisella tularensis
Svensson et al.
J. Bacteriol. 2005;187:3903-3908.
ABSTRACT | FULL TEXT  

Intranasal Vaccination Induces Protective Immunity against Intranasal Infection with Virulent Francisella tularensis Biovar A
Wu et al.
Infect. Immun. 2005;73:2644-2654.
ABSTRACT | FULL TEXT  

Intranasal Interleukin-12 Treatment for Protection against Respiratory Infection with the Francisella tularensis Live Vaccine Strain
Duckett et al.
Infect. Immun. 2005;73:2306-2311.
ABSTRACT | FULL TEXT  

Brief Report: Tularemia Associated With a Hamster Bite--Colorado, 2004
JAMA 2005;293:925-925.
FULL TEXT  

Use of Macrolides and Tetracyclines for Chronic Inflammatory Diseases
Voils et al.
The Annals of Pharmacotherapy 2005;39:86-94.
ABSTRACT | FULL TEXT  

Inhaling to mitigate exhaled bioaerosols
Edwards et al.
Proc. Natl. Acad. Sci. USA 2004;101:17383-17388.
ABSTRACT | FULL TEXT  

Intranasal Interleukin-12 Treatment Promotes Antimicrobial Clearance and Survival in Pulmonary Francisella tularensis subsp. novicida Infection
Pammit et al.
Antimicrob. Agents Chemother. 2004;48:4513-4519.
ABSTRACT | FULL TEXT  

A Francisella tularensis Pathogenicity Island Required for Intramacrophage Growth
Nano et al.
J. Bacteriol. 2004;186:6430-6436.
ABSTRACT | FULL TEXT  

Novel Modification of Lipid A of Francisella tularensis
Phillips et al.
Infect. Immun. 2004;72:5340-5348.
ABSTRACT | FULL TEXT  

Worldwide Genetic Relationships among Francisella tularensis Isolates Determined by Multiple-Locus Variable-Number Tandem Repeat Analysis
Johansson et al.
J. Bacteriol. 2004;186:5808-5818.
ABSTRACT | FULL TEXT  

Methods for Enhanced Culture Recovery of Francisella tularensis
Petersen et al.
Appl. Environ. Microbiol. 2004;70:3733-3735.
ABSTRACT | FULL TEXT  

Virulent and Avirulent Strains of Francisella tularensis Prevent Acidification and Maturation of Their Phagosomes and Escape into the Cytoplasm in Human Macrophages
Clemens et al.
Infect. Immun. 2004;72:3204-3217.
ABSTRACT | FULL TEXT