title: Tularemia, a reemerging disease in northwest Turkey: epidemiological investigation and evaluation of treatment responses.
abstract: An outbreak of tularemia occurred in three provinces in Turkey in February 2004 and reemerged in the same provinces in February 2005. A total of 61 cases, 54 of which were confirmed with the micro-agglutination test, were diagnosed with oropharyngeal tularemia. No culture for Francisella tularensis was attempted, but PCR for F. tularensis was positive in aspiration material of suppurated lymphadenitis of 7 patients. F. tularensis detection with PCR was negative in water samples, but epidemiologic and environmental findings suggested that contaminated water or food was the cause of the outbreaks. Late initiation antibiotic therapy could not prevent suppuration and draining of the involved lymph nodes.
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Zonguldak Karaelmas University, Kozlu, Zonguldak, Turkey. guvencelebi@yahoo.com
authors.forename: Güven
authors.initials: G
authors.lastname: Celebi
authors.forename: Fatma
authors.initials: F
authors.lastname: Baruönü
authors.forename: Ferruh
authors.initials: F
authors.lastname: Ayoğlu
authors.forename: Fikret
authors.initials: F
authors.lastname: Cinar
authors.forename: Aynur
authors.initials: A
authors.lastname: Karadenizli
authors.forename: Mehmet Birol
authors.initials: MB
authors.lastname: Uğur
authors.forename: Suna
authors.initials: S
authors.lastname: Gedikoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000372:Agglutination Tests / Q000379:methods; D002648:Child; D002939:Ciprofloxacin / Q000008:administration & dosage; D004196:Disease Outbreaks; D004318:Doxycycline / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005604:Francisella tularensis / Q000254:growth & development*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D013307:Streptomycin / Q000008:administration & dosage; D014406:Tularemia / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D014421:Turkey / Q000453:epidemiology
chemical_list: D002939:Ciprofloxacin; D004318:Doxycycline; D013307:Streptomycin