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Tularaemia outbreak in Bulgaria.
Iva Christova1, Tzvetan Velinov, Todor Kantardjiev
1Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria. iva_christova@yahoo.com
Scandinavian Journal of Infectious Diseases
|March 15, 2005
Summary
Tularaemia outbreaks in Bulgaria (1998-2003) primarily affected the throat, suggesting food and water contamination from rodents. This study confirms rodent-borne transmission as a key infection source.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Bulgaria experienced two major tularaemia outbreaks in the last 40 years.
- The second outbreak (1998-2003) involved 262 laboratory-confirmed cases.
Purpose of the Study:
- To investigate the epidemiology and sources of the 1998-2003 tularaemia outbreak in Bulgaria.
- To identify the causative agent and transmission routes of tularaemia.
Main Methods:
- Serological confirmation of tularaemia in patients.
- Detection of Francisella tularensis (F. tularensis) using immunofluorescent assay and PCR in clinical samples and environmental sources.
- Isolation and identification of F. tularensis from biopsies, environmental samples, and animals.
Main Results:
- Oropharyngeal tularaemia was the predominant form (89.7%).
- F. tularensis was identified in lymph node biopsies, environmental samples (well, hare, tick), and rodents.
- All isolates were identified as F. tularensis subsp. holarctica seu palaearctica.
Conclusions:
- Rodent-mediated food and water contamination is a significant source of human tularaemia infection.
- The high prevalence of oropharyngeal tularaemia suggests alimentary route as the primary mode of human transmission.