The mortality rate in 3,653 cases of tularemia reported in the United States up to 1933, according to Francis,1 was 4.9 per cent. Simpson2 in 1928 stated that the mortality rate in the United States was 3.7 per cent, but Foshay3 expressed the belief that it is between 6 and 7 per cent. The records of Francis reveal that there are only three states, Connecticut, Maine and Vermont, in which cases of the disease have not been reported. Tularemia is prevalent in Japan and Russia. The occurrence of the disease has recently been reported in Canada, Norway, Sweden and Finland. In England tularemia has occurred only among laboratory workers. Thus, contrary to the general opinion, tularemia, among the infectious diseases, has a relatively high mortality rate and is rather widespread.
Although the literature concerning tularemia is rapidly increasing, there remains much to be elucidated. The causative organism
PESSIN SB. TULAREMIC PNEUMONIA, PERICARDITIS AND ULCERATIVE STOMATITIS. Arch Intern Med (Chic). 1936;57(6):1125–1144. doi:10.1001/archinte.1936.00170100070007
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