Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey

Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. Methodology: The data was provided by the Bolu Provincial Health Directorate. All of th...

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Main Authors: Zafer Mengeloglu, Arif Duran, Ismail Necati Hakyemez, Tarik Ocak, Abdülkadir Kücükbayrak, Mustafa Karadag, Tekin Tas, Hayrettin Akdeniz
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2014-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/3952
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author Zafer Mengeloglu
Arif Duran
Ismail Necati Hakyemez
Tarik Ocak
Abdülkadir Kücükbayrak
Mustafa Karadag
Tekin Tas
Hayrettin Akdeniz
author_facet Zafer Mengeloglu
Arif Duran
Ismail Necati Hakyemez
Tarik Ocak
Abdülkadir Kücükbayrak
Mustafa Karadag
Tekin Tas
Hayrettin Akdeniz
author_sort Zafer Mengeloglu
collection DOAJ
description Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. Methodology: The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female. Results: Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003). Conclusions: In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.
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spelling doaj-art-9dd86e7ce171425a8bcdb212f89f1e122025-08-20T02:57:53ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-03-0180310.3855/jidc.3952Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, TurkeyZafer Mengeloglu0Arif Duran1Ismail Necati Hakyemez2Tarik Ocak3Abdülkadir Kücükbayrak4Mustafa Karadag5Tekin Tas6Hayrettin Akdeniz7Abant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyAbant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyBezmialem University, Faculty of Medicine, Istanbul, TurkeyAbant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyAbant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyBolu Provinceal Health Directorate, Bolu, TurkeyAbant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyAbant Izzet Baysal University, Faculty of Medicine, Bolu, TurkeyIntroduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. Methodology: The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female. Results: Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003). Conclusions: In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.https://jidc.org/index.php/journal/article/view/3952tularemiaTurkeyBolumicroagglutination
spellingShingle Zafer Mengeloglu
Arif Duran
Ismail Necati Hakyemez
Tarik Ocak
Abdülkadir Kücükbayrak
Mustafa Karadag
Tekin Tas
Hayrettin Akdeniz
Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
Journal of Infection in Developing Countries
tularemia
Turkey
Bolu
microagglutination
title Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
title_full Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
title_fullStr Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
title_full_unstemmed Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
title_short Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
title_sort evaluation of patients with tularemia in bolu province in northwestern anatolia turkey
topic tularemia
Turkey
Bolu
microagglutination
url https://jidc.org/index.php/journal/article/view/3952
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