From the start, scientists have viewed the outbreak of tularemia on Martha's Vineyard as an ecological puzzle, never a case of bio-terrorism, despite tularemia's recognized status as a bacteria ideally suited for terrorism.

State public health officials yesterday confirmed this year's third case of pneumonic tularemia, the rare and potentially fatal disease that killed a Chilmark man two years ago and has baffled scientists for the last three summers.

A second round of blood tests has confirmed that two Island men who
fell ill earlier this month with symptoms of pneumonia actually had the
pneumonic form of tularemia, the rare bacterial disease that killed a
Chilmark man almost two years ago.

The Harvard scientists who spent the last four days on the Vineyard
collecting clues that could help them solve the Island's biggest
medical mystery came armed with an unusual tool kit: an aerosol can of
automotive starter fluid, two flowerpots painted blue, a bag of apples
and an empty can of Diet Coke.

Suspicions that tularemia has made a comeback on the Vineyard for
the third summer in a row have prompted a series of new health
advisories aimed at the group of people at highest risk for the disease
- landscapers.

His team of Harvard scientists collected 5,000 dog ticks and trapped 35 skunks and raccoons on the Vineyard this summer. Now, parasitologist Sam Telford wants something more to bring back to the lab in Boston - human blood.

Mr. Telford is on the hunt for clues to the mystery of tularemia, the rare and potentially fatal disease that has infected 23 people on the Island in the last three years, killing one man in 2000 who didn't seek medical treatment soon enough.

Nearly all of the victims were landscapers or people who make a living working outdoors.

A rare bacterial infection called tularemia that killed a Chilmark man three years ago appears to have hit the Island for the fourth summer in a row, possibly infecting as many as four people since May.

State public health officials said yesterday that they are evaluating four probable cases of tularemia, all of them either landscapers or people who work outdoors.

For the fifth summer in a row, a rare and potentially fatal disease called tularemia continues to surface on the Vineyard.

State public health officials yesterday confirmed this year's first case of tularemia: a male landscaper from Edgartown who became ill in early June. Another landscaper from Edgartown is listed as a probable tularemia case, pending follow-up blood tests.

Both men are under 30 years of age and have undergone medical treatment for the disease, public health officials said.

The Vineyard's first tularemia case of the year, a 50-year-old male landscaper, may have contracted the potentially fatal disease after handling a dead rabbit he found while working in Edgartown, state public health officials said this week.

Six cases of tularemia this spring and summer on Martha's Vineyard have been confirmed by the state Department of Public Health.

All six individuals who contracted the disease, who ranged in age from 33 to 67, either were landscaping or were outside near where landscaping was occurring. They contracted the potentially fatal disease by breathing in the Francisella tularemia bacterium between May 13 and July 5, health officials said.

All have been successfully treated with antibiotics for the disease, and are recovering.