Epizootiological and Epidemiological Situation on Tularemia in Russia in 2020, the Forecast for 2021

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Abstract
The purpose of the review is to assess the trends in the development of epizootic activity in various territories of the Russian Federation in order to identify the regions of increased risk of infection of the population with tularemia pathogen in 2021 and to plan and carry out high-priority measures in these regions, such as vaccination, investments in water, sanitation and hygiene infrastructure, epizootiological monitoring of natural foci and other measures aimed at suppressing the activity of natural foci and the development of herd immunity to this infection. In 2020, 41 cases of human infection with tularemia pathogen were registered on the territory of the Russian Federation, 60 % of which occurred in the Northwestern Federal District. Epizootic manifestations of the infection of varying intensity were detected in 55 constituent entities of Russia. Against this background, sporadic cases of tularemia in humans were registered in 14 regions of the country. The most pronounced epidemic complications continue in the territory of Karelia – 23 patients. 12 cultures of Francisella tularensis subsp. holarctica from the ambient environment were isolated in the Vologda (3), Rostov Regions (6), in the Khanty-Mansi Autonomous District (2), and in St. Petersburg (1). Based on the analysis of the data presented, in 2021, epidemic complications in the form of sporadic cases of the disease among the unvaccinated population in the following territories are most likely to occur: Central Federal District – in the Oryol, Ryazan and Yaroslavl Regions, as well as in Moscow; Northwestern Federal District – in the Arkhangelsk and Leningrad Regions, the Republic of Karelia and in St. Petersburg; Volga Federal District – in Tatarstan, Mordovia, Chuvash Republic, Kirov and Orenburg Regions; Ural Federal District – in the Khanty-Mansiysk, Yamalo-Nenets Autonomous Districts and the Tyumen Region; Siberian Federal District – in the Novosibirsk, Kemerovo, Tomsk and Omsk Regions, as well as in the Altai Territory; Far Eastern Federal District – in some regions of Kamchatka and Khabarovsk Territories.

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