[Francisella tularensis and tularemia in Turkey].

Francisella tularensis is a small gram-negative aerobic bacillus which was named after Edward Francis and the location (Tulare County, California) where the organism was discovered. F. tularensis includes four [corrected] subspecies known as tularensis (type A biovar), holarctica (type B biovar) and mediasiatica and novicida [corrected] Tularemia (rabbit fever) is a rare and primarily rural disease which may be transmitted by ingestion, inhalation, or by direct skin contact with rabbits, other rodents and by blood-sucking arthropods. Infection occurs in different forms, such as typhoidal, pneumonic, oculoglandular, oropharyngeal, ulceroglandular, and glandular. The incubation period is about 3-5 days, but may vary between 1 to 21 days, and symptoms vary based on the mode of infection. Infections by F. tularensis subsp. tularensis are generally presented as ulceroglandular form and cause more severe diseases leading 5-60% mortality in untreated patients. F. tularensis subsp. holarctica which is a less virulent organism, mainly cause oropharyngeal form of infection especially in Europe countries as well as in Turkey. Since F. tularensis is extremely virulent organism and is difficult to culture on standard media, laboratory diagnosis is mainly based on the serological assays such as microagglutination or ELISA tests. Streptomycin or gentamycin (for 10-14 days) are the first choise antibiotics for the treatment. Tularemia becomes a reemerging zoonosis in Turkey. The first published tularemia epidemic in Turkey had been reported in 1936 from Thrace region (Luleburgaz town), and the second was in 1945 again in the same location. In recent years, tularemia outbreaks were reported from various regions of Turkey. The reliable data were obtained after 2005 because of the inclusion of this infection into Group C of notification system of communicable diseases by Turkish Ministry of Health. A total of 431 confirmed cases were reported from various provinces according to data of the year 2005. In this review, general characteristics of F. tularensis and its infections have been discussed emphasizing the data related with tularemia in Turkey.