J Med Microbiol Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Willke, A.
Right arrow Articles by Gedikoglu, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Willke, A.
Right arrow Articles by Gedikoglu, S.
Agricola
Right arrow Articles by Willke, A.
Right arrow Articles by Gedikoglu, S.
J Med Microbiol 58 (2009), 112-116; DOI: 10.1099/jmm.0.002279-0
© 2009 Society for General Microbiology
ISSN 0022-2615

An outbreak of oropharyngeal tularaemia linked to natural spring water

A. Willke1, M. Meric1, R. Grunow2, M. Sayan3, E. J. Finke4, W. Splettstößer4, E. Seibold4, S. Erdogan5, O. Ergonul6, Z. Yumuk7 and S. Gedikoglu8

1 Kocaeli University, Medical Faculty, Department of Clinical Bacteriology and Infectious Diseases, Kocaeli, Turkey

2 Robert Koch Institute, Centre for Biological Safety, Berlin, Germany

3 Kocaeli University, Medical Faculty, Clinical Laboratory, PCR Unit, Kocaeli, Turkey

4 Bundeswehr Institute of Microbiology, Munich, Germany

5 Istanbul University, Cerrahpasa Medical Faculty, Department of Public Health, Istanbul, Turkey

6 Marmara University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey

7 Kocaeli University, Medical Faculty, Department of Microbiology, Kocaeli, Turkey

8 Uludag University, Medical Faculty, Department of Microbiology, Bursa, Turkey

Correspondence
M. Meric
drmelihameric{at}gmail.com

Received March 30, 2008
Accepted September 8, 2008

A tularaemia outbreak was investigated involving 188 suspected cases in the Kocaeli region of Turkey between December 2004 and April 2005. A case–control study comprising 135 laboratory-confirmed cases and 55 controls was undertaken to identify risk factors for the development of the outbreak and to evaluate laboratory diagnostic methods. Tularaemia was confirmed by a microagglutination test (MAT) titre of ≥1 : 160 in 90 of the patients. In MAT-negative sera, 23/44 (52 %) were positive by ELISA with Francisella tularensis LPS and 1/9 (11 %) by Western blotting with this antigen. A species-specific PCR was positive in 16/25 (64 %) throat swabs and 8/13 (62 %) lymph node aspirates. Multivariate analysis showed that drinking natural spring water was the leading risk factor for the development of tularaemia (P=0.0001, odds ratio 0.165, 95 % CI 0.790–0.346). The outbreak ceased after abandonment of the suspected natural water springs.

Abbreviations: MAT, microagglutination test.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
INT J SYST EVOL MICROBIOL J MED MICROBIOL MICROBIOLOGY J GEN VIROL ALL SGM JOURNALS
Copyright © 2009 Society for General Microbiology.