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A waterborne tularemia outbreak.

D Greco, G Allegrini, T Tizzi

    European Journal of Epidemiology
    |March 1, 1987
    PubMed
    Summary
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    A waterborne tularemia outbreak in Italy was linked to contaminated drinking water. Public health officials identified 49 cases of tularemia associated with an unchlorinated water system, confirming the pathogen Francisella tularensis.

    Area of Science:

    • Epidemiology
    • Infectious Diseases
    • Public Health

    Background:

    • Tularemia is an infectious disease caused by Francisella tularensis.
    • Waterborne outbreaks of tularemia are rare but can have significant public health implications.

    Purpose of the Study:

    • To describe a waterborne tularemia outbreak in Sansepolcro, Tuscany, Italy.
    • To identify the source and transmission route of the outbreak.

    Main Methods:

    • Retrospective epidemiological investigation of identified cases.
    • Environmental sampling and isolation of the causative agent.
    • Water system analysis.

    Main Results:

    • Forty-nine cases of tularemia were identified within a three-week period in March-April 1982.

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  • All cases presented with laterocervical or sub-mandibular adenitis.
  • A strong association was found between cases and consumption of water from an unchlorinated system.
  • Francisella tularensis type 1 was isolated from wild hares in the vicinity.

    • Conclusions:

    • The outbreak was attributed to a contaminated unchlorinated water supply.
    • Contaminated water is a potential vehicle for Francisella tularensis transmission.
    • Public health measures, including water chlorination, are crucial for preventing future outbreaks.