In high-income countries, oropharyngeal tularemia is associated with hunting or eating infected game or drinking contaminated water.1,2 We describe a cluster of cases of oropharyngeal tularemia that appears to have been caused by the consumption of freshly pressed grape must by grape harvesters volunteering at a vineyard in Rhineland-Palatinate, Germany, in October 2016.
Reference:
N Engl J Med 2018; 379:197-199. https://www.nejm.org/doi/full/10.1056/NEJMc1800353
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