[Evolution of serological characteristics in 26 patients with tularemia three years after the outbreak]

Tularemia was an unknown zoonosis in our region until the first quarter of 1998. The outbreak that took place on those dates has made possible to study some scantly known characteristics of the disease, as are the determinants for the persistence of a high antibody titer.

Between March and May, 2001, a clinical-analytical control was carried out in 26 patients who showed tularemia in the first quarter of 1998.

The clinical forms during the acute phase were: ulceroglandular (46.2% of patients), nodal (26.9%), typhoid (15.4%) and pharyngeal (11.5%). Antibiotics most prescribed were streptomycin and doxycycline. Nine patients showed sequelae three years later. The arithmetical mean of antibody titer declined from 1/1011 in 1998 to 1/187 in 2001. 76.92% of the patients maintained an antibody titer equal or higher than 1/160 three years after the acute phase. A significant relation between the initial antibody titer and the antibody titer registered in the late phase was observed. A relationship between final antibody titer and prescribed antibiotic, presence of sequelae, gender, or age was not demonstrated.

The antibody titer in the presence of Francisella tularensis is high in an important percentage of the patients along years. We should reconsider the standard diagnostic criteria to our community, accepting as a certainty diagnosis exclusively the presence of a demonstrative culture or the existence of seroconversion.