An outbreak of oropharyngeal tularaemia linked to natural spring water
Open Access
- 1 January 2009
- journal article
- Published by Microbiology Society in Journal of Medical Microbiology
- Vol. 58 (1), 112-116
- https://doi.org/10.1099/jmm.0.002279-0
Abstract
A tularaemia outbreak was investigated involving 188 suspected cases in the Kocaeli region of Turkey between December 2004 and April 2005. A case–control study comprising 135 laboratory-confirmed cases and 55 controls was undertaken to identify risk factors for the development of the outbreak and to evaluate laboratory diagnostic methods. Tularaemia was confirmed by a microagglutination test (MAT) titre of ≥1 : 160 in 90 of the patients. In MAT-negative sera, 23/44 (52 %) were positive by ELISA with Francisella tularensis LPS and 1/9 (11 %) by Western blotting with this antigen. A species-specific PCR was positive in 16/25 (64 %) throat swabs and 8/13 (62 %) lymph node aspirates. Multivariate analysis showed that drinking natural spring water was the leading risk factor for the development of tularaemia (P=0.0001, odds ratio 0.165, 95 % CI 0.790–0.346). The outbreak ceased after abandonment of the suspected natural water springs.Keywords
This publication has 13 references indexed in Scilit:
- Evaluation of clinical, laboratory, and therapeutic features of 145 tularemia cases: the role of quinolones in oropharyngeal tularemiaAPMIS, 2008
- A novel screening ELISA and a confirmatory Western blot useful for diagnosis and epidemiological studies of tularemiaEpidemiology and Infection, 2005
- Tularaemia in Europe: An Epidemiological OverviewScandinavian Journal of Infectious Diseases, 2004
- TularaemiaEuropean Respiratory Journal, 2003
- TularemiaClinical Microbiology Reviews, 2002
- Tularemia Outbreak Investigation in Kosovo: Case Control and Environmental StudiesEmerging Infectious Diseases, 2002
- Waterborne Outbreak of Tularemia Associated with Crayfish FishingEmerging Infectious Diseases, 2001
- Tularemia in Bursa, Turkey: 205 cases in ten yearsEuropean Journal of Epidemiology, 2000
- Francisella tularensis isolation from various clinical specimensClinical Microbiology & Infection, 1996
- Tularemia in Otolaryngologic Practice: An Analysis of 127 CasesJAMA Otolaryngology–Head & Neck Surgery, 1986