Tularemia in children, Turkey, September 2009-November 2012.

Hasan Tezer,Aslınur Ozkaya-Parlakay,Belgin Gülhan,Anil Tapisiz,Soner Kara,Saliha Kanik-Yuksek,Mustafa Erkocoglu,Meltem Polat,Selcuk Kilic,Ahmet Demir,Ilker Devrim,Hakan Aykan

doi:10.3201/eid2101.131127

Abstract

Tularemia, a zoonotic disease caused by Francisella tularensis, is found throughout most of the Northern Hemisphere. It is not well known and is often misdiagnosed in children. Our aim with this study was to evaluate the diagnosis, treatment, and prognosis for 100 children with tularemia in Turkey. The mean patient age was 10.1 ± 3.5 years (range 3-18 years), and most (63%) patients were male. The most common physical signs and laboratory findings were cervical lymphadenopathy (92%) and elevated erythrocyte sedimentation rate (89%). Treatment response was higher and rate of relapse lower for children 5-10 years of age than for those in other age groups. Associated with treatment failure were female sex, treatment delay of ≥16 days, and use of doxycycline. Tularemia is endemic to Turkey, and the number of cases has been increasing among children as well as adults.

Highlights

Tularemia, a zoonotic disease caused by Francisella tularensis, is found throughout most of the Northern Hemisphere
Tularemia is endemic to Turkey, and most cases are reported to occur in late summer or early autumn [10]
Most studies have examined adult populations, tularemia can occur in patients of all ages and is more prevalent among children 5–9 years of age and in persons older than 75 years [6,10,11,12,15,16,17]

Summary

Introduction

A zoonotic disease caused by Francisella tularensis, is found throughout most of the Northern Hemisphere. It is not well known and is often misdiagnosed in children. Tularemia occurs throughout most of the Northern Hemisphere, and the number of cases is increasing in various parts of Europe, especially in the Balkans, Turkey, and Scandinavian countries. The ulceroglandular form has been reported as the most prevalent clinical form of the disease in northern Europe, whereas the oropharyngeal form has been most commonly reported in Turkey, Bulgaria, and Kosovo and is attributed to the consumption of contaminated water and food [5,6,7,8,9,10]. Our aim was to demonstrate the clinical features and outcomes for children with tularemia

Objectives

Methods

Results

Conclusion