[Tularaemia outbreak in Kosovo]

The occurrence of a first case of tularaemia in Kosovo in 2000 and the subsequent appearance of other cases provided us with an opportunity to study this infection, seen at the Moroccan medical-surgical field hospital set up in Mitrovica during our stay in Kosovo.

This was a prospective study involving all patients with suspected tularaemia consulting at the hospital and subsequently referred to dermatologists and the ENT practitioners between 3 January and 27 August 2002. For each patient, clinical and treatment history data were studied using a preset form. Investigations were requested to confirm the diagnosis or examine the consequences and individual characteristics for all patients. Diagnosis was based upon clinical findings and epidemiological context, and was confirmed by serology.

Seven cases were seen and all involved women, two of whom were pregnant. Two cases were familial. Three patients lived in the country and 4 in towns. The clinical picture consisted of suppurative adenitis preceded by pharyngitis. Six patients required surgical drains due to late consultation and after failure of antibiotic therapy. All patients were successfully cured.

Our 7 cases are original since they occurred in a specific context of ecological upset resulting from war. Our study confirms the reality of tularaemia in Kosovo. Control of this epidemic depends upon improvement of living conditions for the population.