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...

Full description

Saved in:
Bibliographic Details
Main Authors: Radka Komitova, Rumiana Nenova, Plamen Padeshki, Ivan Ivanov, Vassil Popov, Petar Petrov
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2010-09-01
Series:Journal of Infection in Developing Countries
Subjects:
Online Access:https://jidc.org/index.php/journal/article/view/712
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849323625420685312
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
description 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.
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