Tularemia Outbreak, Bulgaria, 1997–2005

Kantardjiev, Todor; Ivanov, Ivan N.; Velinov, Tzvetan; Padeshki, Plamen; Popov, B.; Nenova, Roumiana; Mincheff, Milcho

doi:10.3201/eid1204.050709

Cited by 51 publications

(46 citation statements)

References 7 publications

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“…In central European foci, hares appeared to be the main carrier and source of tularemia in humans, whereas ticks harbored by hares were the perennial reservoir of F. tularensis (Sjostedt, 2007b). Several outbreaks of tularemia have been reported in the literature, but they were not associated with transmission by ticks (Kantardjiev et al, 2006;Reintjes et al, 2002;Payne et al, 2005;Perez-Castrillon et al, 2001). The clinical symptoms of tularemia depend upon the route of infection.…”

Section: Relapsing Fever Borreliosismentioning

confidence: 99%

Update on tick-borne bacterial diseases in Europe

et al. 2009

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Summary :In recent years, the prevalence of tick-borne bacterial diseases has significantly increased in European countries. The emergence and reemergence of these illnesses are attributed to changes in the environment and human behavior. Several diseases are caused by bacteria initially isolated from ticks and subsequently considered pathogenic. It is necessary to consider the bacteria found in arthropods capable of biting humans as potential human pathogens. Here we review the clinical and epidemiological data on bacterial tick-borne diseases in European countries. We focus on the epidemiological and clinical aspects of tick-borne rickettsioses and give an overview of other tick-borne illnesses as well as the emergence and re-emergence of these diseases. Résumé : ACTUALITÉ SUR LES MALADIES BACTÉRIENNES TRANSMISES PAR

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Section: Relapsing Fever Borreliosismentioning

confidence: 99%

Update on tick-borne bacterial diseases in Europe

et al. 2009

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“…From October 1997 to April 2007, 298 cases of tularaemia were registered. More than 95 % of the patients had the oropharyngeal form of the disease (Kantardjiev et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Characterization and genotyping of strains of Francisella tularensis isolated in Bulgaria

Marinov

Georgieva

Ivanov

et al. 2009

Journal of Medical Microbiology

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A tularaemia focus was detected in 1998 in Bulgaria, in an area where tularaemia had never been reported. The properties of Francisella tularensis subsp. holarctica strains isolated from 1998 to 2005 were studied. The strains showed heterogeneity, based on acid production from glycerol and erythromycin susceptibility. Genotyping by analysis of seven loci containing variable-number tandem repeats showed four genotypes among eight strains.

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“…A recent Bulgarian study has shown high prevalence of F. tularensis in rodents (22%) trapped in the neighboring Pernik region and tested by PCR [21]. Moreover, F. tularensis has been cultivated from four private wells in the same place [9]. We suggest that the route of transmission might be by ingestion of uncooked food or, less likely, contaminated water.…”

Section: Discussionmentioning

confidence: 80%

“…The incidence increased again in 2003 in the same areas. While recent reports in Bulgarian publications have addressed mainly the epidemiological and microbiological features of tularemia [7,9] …”

Section: Introductionmentioning

confidence: 99%

Tularemia in Bulgaria 2003-2004

Komitova

Nenova

Padeshki

et al. 2010

J Infect Dev Ctries

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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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Tularemia Outbreak, Bulgaria, 1997–2005

Cited by 51 publications

References 7 publications

Update on tick-borne bacterial diseases in Europe

Update on tick-borne bacterial diseases in Europe

Characterization and genotyping of strains of Francisella tularensis isolated in Bulgaria

Tularemia in Bulgaria 2003-2004

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