(CIT): Dr. Telford will discuss the series of 59 cases of tularemia that have occurred on Martha's Vineyard since the year 2000, some 60% of which have apparently resulted from inhalation of Francisella tularensis originating in a variety of natural sources. These cases are summarized in the recent publication: Matyas BT, Nieder HS, Telford SR. Pneumonic Tularemia on Martha's Vineyard: Clinical, Epidemiologic and Ecological Characteristics. Ann N Y Acad Sci. 2007 Apr 18. The initial 2000 outbreak is described in: Feldman KA, Enscore RE, Lathrop SL, Matyas BT, McGuill M, Schriefer ME, Stiles-Enos D, Dennis DT, Petersen LR, Hayes EB. An outbreak of primary pneumonic tularemia on Martha's Vineyard. N Engl J Med. 2001 Nov 29;345(22):1601-6. Although pneumonic tularemia is rare in nature, it is of concern to biodefense, because it would be the predominant form of disease that would result from bioterror attack with aerosolized F. tularensis. EPBIG is a scientific exchange on topics related to the public health challenges posed by natural and man-made emergencies, including acts of terrorism.