Outbreak News Today reports that in a follow-up on a report about two weeks ago, Swedish health officials are reporting a significant rise in tularemia cases since the end of July.

As of Monday, about 560 human cases have been reported, much more this time of year than usual and even more than 2015 when 859 people across the country suffered  from the illness.

Most cases of illness are reported from central Sweden (the Dalarna region, Gävleborg and Örebro), but an increasing number of reports are also starting to come in from other regions, especially in northern Sweden.

Since the number of illness cases is usually highest in September in Sweden, the outbreak is expected to grow further in the coming weeks.

Infections in Sweden are mainly seen in forest and field hares and rodents, but the disease has been reported in several other species, including other mammals, birds, amphibians, insects, ticks and unicellular animals.

Tularemia, or harpest as it’s known as in Sweden, is one of the most common native zoonoses in people in Sweden. People are infected mainly through mosquitoes, but also through direct contact with sick or dead animals and by inhalation of, for example, infectious dust.