<unk>  is most common in the Northern Hemisphere, including North America and parts of Europe and Asia. It occurs between 30º and 71º north latitude. In the United States, although records show that<unk>  was never particularly common, incidence rates continued to drop over the course of the 20th century. Between 1990 and 2000, the rate dropped to less than 1 per one million, meaning the disease is extremely rare in the United States today. In Europe,<unk>  is generally rare, though outbreaks with hundreds of cases occur every few years in neighboring Finland and Sweden. In Sweden over a period from 1984 to 2012 a total of 4,830 cases of<unk>  occurred (most of the infections were acquired within the country). About 1.86 cases per 100,000 persons occur each year with higher rates in those between 55 and 70. Outbreaks From May to October 2000, an outbreak of<unk>  in Martha's Vineyard, Massachusetts, resulted in one fatality, and brought the interest of the United States Centers for Disease Control and Prevention (CDC) as a potential investigative ground for aerosolised Francisella tularensis. For a time, Martha's Vineyard was identified as the only place in the world where documented cases of<unk>  resulted from lawn mowing. However, in May 2015 a resident of Lafayette, Colorado, died from aerosolised F. tularensis, which was also connected to lawn mowing, highlighting this new vector of risk. An outbreak of<unk>  occurred in Kosovo in 1999-2000. In 2004, three researchers at Boston Medical Center, in Massachusetts, were accidentally infected with F. tularensis, after apparently failing to follow safety procedures. In 2005, small amounts of F. tularensis were detected in the National Mall area of Washington, D.C., the morning after an antiwar demonstration on September 24, 2005. Biohazard sensors were triggered at six locations surrounding the Mall. While thousands of people were potentially exposed, no infections were reported. The detected bacteria likely originated from a natural source, not from a bioterror attempt. In 2005, an outbreak occurred in Germany amongst participants in a hare hunt. About 27 people came into contact with contaminated blood and meat after the hunt. Ten of the exposed, aged 11 to 73, developed<unk> . One of these died due to complications caused by chronic heart disease.<unk>  is endemic in the Gori region of the Eurasian country of Georgia. The last outbreak was in 2006. The disease is also endemic on the uninhabited Pakri Islands off the northern coast of Estonia. Used for bombing practice by Soviet forces, chemical and bacteriological weapons may have been dropped on these islands. In July 2007, an outbreak was reported in the Spanish autonomous region of Castile and León and traced to the plague of voles infesting the region. Another outbreak had taken place ten years before in the same area. In January 2011, researchers searching for brucellosis among feral pig populations in Texas discovered widespread<unk>  infection or evidence of past infection in feral hog populations of at least two Texas counties, even though<unk>  is not normally associated with pigs at all. Precautions were recommended for those who hunt, dress, or prepare feral hogs. Since feral hogs roam over large distances, concern exists that<unk>  may spread or already be present in feral hogs over a wide geographic area. In November 2011, it was found in Tasmania. Reports claimed it to be the first in the Southern Hemisphere. However, the causative organism was documented to have been isolated from a foot wound in the Northern Territory in 2003. In 2014, at least five cases of<unk>  were reported in Colorado and at least three more cases in early 2015, including one death as a result of lawn mowing, as noted above. In the summer of 2015, a popular hiking area just north of Boulder was identified as a site of animal infection and signs were posted to warn hikers.
Tularemia
Scabies
Chancroid
Smallpox
Chickenpox
Leprosy
Mumps
Polymeal