Tularaemia outbreak due to consumption of natural spring water in Karamürsel, Turkey

Abstract number: 1733_551

Meric M., Sayan M., Willke A., Gedikoglu S.

Objective: To describe a recent tularaemia outbreak resulted from consumption of spring water in a village of Karamürsel/Turkey and to present the anti-epidemic measures implemented.

Methods: After diagnosis as oropharyngeal tularaemia of two patients come from the village, a field investigation was performed at the region in March 2005. Clinical samples from the patients and water samples from the natural spring water were obtained and microbiological investigation was performed. A questionnaire designed to determine the risk factors for the infection.

Results: Totally 17 patients were diagnosed as tularaemia with their clinics and serological results. The patients were treated with streptomycin, or ciprofloxacin, or doxycycline, or streptomycin+ doxycycline. All the patients recovered. Francisella tularensis PCR was found to be positive in water samples. After then spring water collected in a storage, chlorinated and then allowed to delivery. The outbreak was controled after hygienic measures.

Conclusion: Oropharyngeal tularaemia is dominant in our region and Turkey which could be associated with the consumption of the contaminated water. In this small outbreak, we showed the F. tularensis DNA by real-time PCR assay. After establishing hygienic regulations the outbreak was stopped. Surveillance and early alert system for tularaemia and field investigation teams are nessesary for detection and prevention of the outbreaks.