Tularemia in Bulgaria 2003-2004
Introduction: Tularemia is an uncommon but potentially fatal zoonosis. А second outbreak of tularemia in Bulgaria, about 40 years after the first, occurred in 1997 in two western regions, near the Serbian border. In 2003 tularemia reemerged in the same foci. This retrospective study aimed to evalua...
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The Journal of Infection in Developing Countries
2010-09-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/712 |
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| author | Radka Komitova Rumiana Nenova Plamen Padeshki Ivan Ivanov Vassil Popov Petar Petrov |
| author_facet | Radka Komitova Rumiana Nenova Plamen Padeshki Ivan Ivanov Vassil Popov Petar Petrov |
| author_sort | Radka Komitova |
| collection | DOAJ |
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Introduction: Tularemia is an uncommon but potentially fatal zoonosis. А second outbreak of tularemia in Bulgaria, about 40 years after the first, occurred in 1997 in two western regions, near the Serbian border. In 2003 tularemia reemerged in the same foci. This retrospective study aimed to evaluate the clinical characteristics and the efficacy of antibiotic therapy in a tularemia resurgence in the Slivnitza region in 2003-2004.
Methodology: A total of 26 cases were evaluated. Using medical records, the following data were collected for all patients: symptoms, physical signs, and microbiology results of agglutination tests, cultures and PCR assays.
Results: Twenty-four of 26 suspected tularemia patients were laboratory confirmed by agglutination test and/or culture. Fifteen (57.7%) patients had clinical presentation compatible with oropharyngeal, 8 (30.8%) with glandular, and 3 (11.5%) with oculoglandular tularemia. The most frequent symptoms were swollen neck (84.6%) and sore throat (76.9%). Lymphadenopathy (100%) was the most common finding. Francisella tularensis (F. tularensis) was detected by PCR, providing a definitive diagnosis in 82.3% of the cases. All the patients were treated with antibiotics considered effective against F. tularensis; however, therapeutic failure was observed in 23.1% of the cases, which was related to a delay in the initiation of antibiotics.
Conclusion: The tularemia outbreak in west Bulgaria near the Serbian border was probably food-borne, associated with a surge in the rodent population. The oropharyngeal form was the most common. Although the disease runs a benign course, late initiation of antimicrobial therapy might delay complete recovery.
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| format | Article |
| id | doaj-art-0b849bab720740b7b2766a7fd0d08b9a |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2010-09-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-0b849bab720740b7b2766a7fd0d08b9a2025-08-20T03:48:58ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802010-09-0141110.3855/jidc.712Tularemia in Bulgaria 2003-2004Radka Komitova0Rumiana Nenova1Plamen Padeshki2Ivan Ivanov3Vassil Popov4Petar Petrov5Infectious Diseases Departnment,University Hospital, PlevenNational Center for Infectious and Parasitic DiseasesNational Center for Infectious and Parasitic Diseases, SofiaNational Center for Infectious and Parasitic Diseases, SofiaNational Center for Infectious and Parasitic Diseases, SofiaInfectious Diseases Department, University Hospital “St. Anna”, Sofia Introduction: Tularemia is an uncommon but potentially fatal zoonosis. А second outbreak of tularemia in Bulgaria, about 40 years after the first, occurred in 1997 in two western regions, near the Serbian border. In 2003 tularemia reemerged in the same foci. This retrospective study aimed to evaluate the clinical characteristics and the efficacy of antibiotic therapy in a tularemia resurgence in the Slivnitza region in 2003-2004. Methodology: A total of 26 cases were evaluated. Using medical records, the following data were collected for all patients: symptoms, physical signs, and microbiology results of agglutination tests, cultures and PCR assays. Results: Twenty-four of 26 suspected tularemia patients were laboratory confirmed by agglutination test and/or culture. Fifteen (57.7%) patients had clinical presentation compatible with oropharyngeal, 8 (30.8%) with glandular, and 3 (11.5%) with oculoglandular tularemia. The most frequent symptoms were swollen neck (84.6%) and sore throat (76.9%). Lymphadenopathy (100%) was the most common finding. Francisella tularensis (F. tularensis) was detected by PCR, providing a definitive diagnosis in 82.3% of the cases. All the patients were treated with antibiotics considered effective against F. tularensis; however, therapeutic failure was observed in 23.1% of the cases, which was related to a delay in the initiation of antibiotics. Conclusion: The tularemia outbreak in west Bulgaria near the Serbian border was probably food-borne, associated with a surge in the rodent population. The oropharyngeal form was the most common. Although the disease runs a benign course, late initiation of antimicrobial therapy might delay complete recovery. https://jidc.org/index.php/journal/article/view/712Francisella tularensisoropharyngeal tularemiatherapeutic failure |
| spellingShingle | Radka Komitova Rumiana Nenova Plamen Padeshki Ivan Ivanov Vassil Popov Petar Petrov Tularemia in Bulgaria 2003-2004 Journal of Infection in Developing Countries Francisella tularensis oropharyngeal tularemia therapeutic failure |
| title | Tularemia in Bulgaria 2003-2004 |
| title_full | Tularemia in Bulgaria 2003-2004 |
| title_fullStr | Tularemia in Bulgaria 2003-2004 |
| title_full_unstemmed | Tularemia in Bulgaria 2003-2004 |
| title_short | Tularemia in Bulgaria 2003-2004 |
| title_sort | tularemia in bulgaria 2003 2004 |
| topic | Francisella tularensis oropharyngeal tularemia therapeutic failure |
| url | https://jidc.org/index.php/journal/article/view/712 |
| work_keys_str_mv | AT radkakomitova tularemiainbulgaria20032004 AT rumiananenova tularemiainbulgaria20032004 AT plamenpadeshki tularemiainbulgaria20032004 AT ivanivanov tularemiainbulgaria20032004 AT vassilpopov tularemiainbulgaria20032004 AT petarpetrov tularemiainbulgaria20032004 |