Şaban GÜRCAN, Gamze SARAÇOĞLU VAROL, Emine Neşe ÖZKAYIN, Binay VATANSEVER, Cemal ÇİÇEK, Aynur KARADENİZLİ, Şemsi Zafer ÖZTÜRK

Tularemia as a result of outdoor activities for children in the countryside

To investigate the features of a new tularemia outbreak that occurred in the Thrace region. Materials and methods: The research team visited the village after the identification of the index case. Serum and throat samples were taken from 41 villagers who were examined, and environmental samples were taken in order to identify the source of the outbreak. Culture, serology, and molecular methods were used to search for Francisella tularensis in these samples. Results: A total of 8 children were diagnosed with tularemia. The adults and all of the other children were seronegative for tularemia. All of the patients had a history of swimming in a pool filled with water from a local stream, and contact with stream water was calculated to increase the risk of developing the disease 9.3-fold. Polymerase chain reaction analysis was positive in a lymph node aspirate of the index case and in the home tap water of 3 patients as well as in the spring water and stream water in the village. Francisella tularensis could not be isolated from any culture of samples. Interestingly, the waterborne tularemia outbreak affected only children. Conclusion: Although tularemia has been not reported from Tekirdağ Province for 74 years, the disease reemerged in the region due to the removal of hygienic measures. These clues may signify that the agent had maintained its presence in the region for many years.

Anahtar Kelimeler:

Key words: Francisella tularensis, tularemia, outbreak, waterborne diseases, Thrace region of Turkey

Tularemia as a result of outdoor activities for children in the countryside

Keywords:

Key words: Francisella tularensis, tularemia, outbreak, waterborne diseases, Thrace region of Turkey,

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Gürcan Francisella tularensis and tularemia in Turkey. Ş. Mikrobiyol Bul 2007; 41: 621-36 (in Turkish). 2. Gürcan Ş, Eskiocak M, Varol G, Uzun C, Tatman-Otkun M, Şakru N et al. Tularemia re-emerging in European part of Turkey aft er 60 years. Jpn J Infect Dis 2006; 59: 391-3.
Gürcan Ş, Karabay O, Karadenizli A, Karagöl Ç, Kantardjiev T, Ivanov IN. Characteristics of the Turkish isolates of Francisella tularensis. Jpn J Infect Dis 2008; 61: 223-5.
Padeshki PI, Ivanov IN, Popov B, Kantardjiev TV. Th e role of birds in dissemination of Francisella tularensis: fi rst direct molecular evidence for bird-to-human transmission. Epidemiol Infect 2009; 138: 376-9. 5. Broman T, Th elaus J, Andersson AC, Backman S, Wikstrom P, Larsson E et al. Molecular detection of persistent Francisella tularensis subspecies holarctica in natural waters. Int J Microbiol 2011; doi: 10.1155/2011/851946.
Vodopianov AS, Pavlovich NV, Vodopianov SO, Suchkov IIu, Pichurina NL, Mishankin BN. Genotyping of the Francisella tularensis strains isolated from natural foci of tularemia in the Rostov region by multilocus VNTR analysis. Mol Gen Mikrobiol Virusol 2004; 2: 24-8 (in Russian). 7. Whitehouse CA, Hottel HE. Comparison of fi ve commercial DNA extraction kits for the recovery of Francisella tularensis DNA from spiked soil samples. Mol Cell Probes 2007; 21: 92-6.
Kılıç S. A general overview of Francisella tularensis and the epidemiology of tularemia in Turkey. Flora 2010; 15: 37-58. 9. Kaygusuz S, Arikan O, Azkur K, Simsek H, Gazyagci S, Muluk N et al. Epidemia of tularemia in Central Anatolia. JAVA 2010; 9: 1702-6.
Ugur KS, Ark N, Kilic S, Kurtaran H, Kosehan D, Gunduz M. Th ree cases of oropharyngeal tularemia in Turkey. Auris Nasus Larynx 2011; 38: 532-7.
Karadenizli A, Gurcan S, Kolayli F, Vahaboglu H. Outbreak of tularaemia in Golcuk, Turkey in 2005: report of 5 cases and an overview of the literature from Turkey. Scand J Infect Dis 2005; 37: 712-6.
Ellis J, Oyston PC, Green M, Titball RW. Tularemia. Clin Microbiol Rev 2002; 15: 631-46.
Oral B. Immunopathogenesis and pathology of tularemia . In: Gürcan Ş (ed). Francisella tularensis ve Tularemi. İstanbul: Nobel Tıp Kitabevleri; 2009. p.193-200 (in Turkish).
Grunow R, Splettstoesser W, McDonald S, Otterbein C, O’Brien T, Morgan C et al. Detection of Francisella tularensis in biological specimens using a capture enzyme-linked immunosorbent assay, an immunochromatographic handheld assay, and a PCR. Clin Diagn Lab Immunol 2000; 7: 86-90.
Celebi S, Hacimustafaoglu M, Gedikoglu S. Tularemia in children. Indian J Pediatr 2008; 75: 1129-32.