Tularemia in Çanakkale province, Marmara region, Turkey: a 10 years’ experience

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Infectious Diseases and Tropical Medicine, vol.8, pp.1-6, 2022 (Peer-Reviewed Journal)


OBJECTIVE: In this retrospective study, we aimed to perform a clinical and laboratory evaluation of the cases of tularemia in the last 10 years in Çanakkale province, Marmara region, Turkey, which is considered an endemic area for the disease.

PATIENTS AND METHODS: Patients aged 11 years and older who were referred to our outpatient clinic between January 2011 and December 2020 and were diagnosed with Tularemia based on clinical findings and laboratory test results were included in the study. Sociodemographic, possible risk factors for this disease, physical examination findings, laboratory test results, treatments, and outcomes of the patients were analyzed.

RESULTS: During the study period, 264 people were tested for tularemia and 28 patients were diagnosed. The mean age was 47.42 (11-82) years, and 20 (71.4%) of them were women. 89.2% of the cases were diagnosed in 2019. Living in rural areas (n=18, 64.3%), using a neighborhood/village fountain as a water source (n =18, 64.3%), not knowing the chlorination status of drinking water (n=24, 85.7%), and the presence of a similar disease in the neighborhood/village (n=18, 64.3%) were the most common risk factors for tularemia. The most common form of tularemia is the oropharyngeal form (71.4%); presence of enlarged lymph nodes and/or painful lymph nodes (89.2%) and sore throat (75%) were the most common symptoms reported. The mean time to diagnosis was 40.5±2.9 days. The development of suppuration was detected in 49.9% of the cases.

CONCLUSIONS: Tularemia outbreaks continue to be reported in the Marmara Region, where the first tularemia cases were detected in Turkey. Tularemia should be included in the differential diagnosis in patients with neck lymphadenopathy, sore throat, and fever, especially those living in endemic areas.