An Outbreak of Tularemia in a Colony of Outdoor-Housed Rhesus Macaques (Macaca mulatta)

Since an epizootic and detection of clinical cases of tularemia (Francisella tularensis) in 1996 at the Oregon National Primate Research Center, only 8 cases were identified in the succeeding 13 y. However, within a period of 7 mo, primarily during Winter 2010, 6 rhesus macaques were confirmed positive for Francisella tularensis type B by the Centers for Disease Control and Prevention by culture and fluorescent antibody testing. All cases had similar gross pathologic findings, which included necrotizing splenitis and lymphadenitis. Recent colony management efforts have focused on minimizing nonhuman primate exposure to commonly observed reservoir species and controlling rodent access to corral-style housing. Strategies continue to evolve with regard to managing a large breeding colony of nonhuman primates in the presence of this threat.Abbreviation: ONPRC, Oregon National Primate Research CenterFrancisella tularensis, the causative agent of tularemia, is a small pleomorphic gram-negative coccobacillus.¹¹ Severe disease and potentially death in humans can result from exposure to as few as 10 cfu of this highly infectious organism.^7,10 The disease is also known as rabbit fever and deer-fly fever, reflecting 2 common sources of infection for humans.³ F. tularensis is classified by the United States Department of Health and Human Services as a Category A Select Agent.⁶ It is considered a potential agent of biologic warfare, and in fact, has been weaponized and stockpiled in the past.¹⁰ The 2 biovars that are referenced most frequently in published human and nonhuman primate literature are tularensis (type A) and holarctica (formerly paleartica; type B).^4,12,13,23 An additional biovar, novicida (type C), has been described, but its virulence in humans is decreased due to its lack of a capsule.¹⁰Tularemia is endemic to many parts of the northern hemisphere, which includes the region surrounding the Oregon National Primate Research Center (ONPRC), an AAALAC-accredited facility.²⁰ Tularemia has one of the broadest host ranges of all bacteria, encompassing well over 200 mammalian species primarily, in addition to birds, amphibians, fish, and various arthropods such as fleas, ticks, mosquitoes, and flies.^10,15,19,20 The ONPRC is located in a mixed forest and field environment which is bordered by wetlands and residential neighborhoods outside of Portland. More than 4500 nonhuman primates are housed here, and most live outdoors in breeding groups. Therefore, exposure to this potentially life-threatening and zoonotic pathogen is inevitable, due to its persistence in the environment and the close proximity of several reservoir species. Presumed reservoir species commonly observed at ONPRC include meadow voles (Microtus pennsylvanicus), brown rats (Rattus norvegicus), deer mice (genus Peromyscus), house mice (Mus musculus), and California ground squirrels (Spermophilus beecheyi). Potential arthropod vectors that are monitored regularly at ONPRC include biting flies and mosquitoes. At this time, testing of prospective rodent carriers for tularemia is ongoing; therefore, in the interest of caution, all of the rodent and arthropod species listed are considered potential carriers of the disease.Tularemia was first recognized at the ONPRC in 1996 during an epizootic that resulted in 24 deaths among corral-housed rhesus macaques. Serology results from banked sera and sera collected during and after the outbreak demonstrated a seroconversion rate of approximately 25% in 723 animals. During the succeeding 13 y, only 8 sporadic cases were diagnosed. However, within a period of 3 mo during the winter of 2010, 5 rhesus macaques were diagnosed with Francisella tularensis type B by the Centers for Disease Control and Prevention (Atlanta, GA). Four months later, an additional case was confirmed. All 6 macaques were younger than 1 y and were assigned to a breeding colony protocol approved by the ONPRC Animal Care and Use Committee. The current report describes the clinical signs and gross and histologic findings associated with these cases, as well as methods for prevention and control of future cases of disease.