土拉菌病的流行病学。
Epidemiology of tularemia.
机构信息
Department of Medical Microbiology, Trakya University Faculty of Medicine, Edirne, Turkey.
出版信息
Balkan Med J. 2014 Mar;31(1):3-10. doi: 10.5152/balkanmedj.2014.13117. Epub 2014 Mar 1.
Tularemia is considered to have existed in Anatolia for several thousand years. There are suspicions regarding its use in biological warfare in the Neshite-Arzawan conflict. The causative agent of tularemia may have first been used as a biological weapon in 1320-1318 BC. The disease has recently become a significant re-emerging disease globally as well as in Turkey. In the period of 2001-2010, Kosovo had the highest annual incidence in Europe at a rate of 5.2 per 100,000. Sweden, Finland, Slovakia, Czech Republic, Norway, Serbia-Montenegro, Hungary, Bulgaria, and Croatia follow with rates of 2.80, 1.19, 1.0, 0.81, 0.42, 0.4, 0.36, 0.21, and 0.15 per 100,000 people, respectively. Tularemia in Turkey was first reported in the soldiers living in the region very close to the Kaynarca Stream of Thrace in 1936. It has started to gain more and more importance, especially in recent decades in Turkey, due to a very high number of cases and its spread throughout the country. A total of 431 tularemia cases were recorded in Turkey in 2005, but a significant reduction was observed in the number of the cases in the next three years; the number of patients decreased to 71 in 2008. The number of cases increased again in 2009 and continued in subsequent years. The number of cases reached 428, 1531, 2151, and 607 in 2009, 2010, 2011, and 2012, respectively. The number of cases peaked in 2011 in Turkey, and was in fact higher than the total number of cases in all European Union countries. The number of cases is higher in females than males in Turkey. In Turkey, 52% of cases of tularemia diagnoses occur from December to March and the most common clinical presentation is the oropharyngeal form caused by contaminated water. Rodents are the most likely sources of tularemia outbreaks in Turkey as well as in Kosovo. Organisms such as ticks, flies and mosquitoes are vectors of tularemia transmission to mammals. Because ticks can carry the bacteria by both transovarial and transstadial transmission, they play a role in the life cycle of tularemia as both reservoir and vector.
土拉菌病被认为在安纳托利亚存在了几千年。在尼什特-阿尔扎万冲突中，人们怀疑它被用于生物战。土拉菌病的病原体可能在公元前 1320 年至 1318 年首次被用作生物武器。最近，这种疾病在全球以及土耳其再次成为一种重要的新兴疾病。在 2001 年至 2010 年期间，科索沃的年发病率在欧洲最高，为每 10 万人 5.2 例。瑞典、芬兰、斯洛伐克、捷克共和国、挪威、塞尔维亚-黑山、匈牙利、保加利亚和克罗地亚的发病率分别为每 10 万人 2.80、1.19、1.0、0.81、0.42、0.4、0.36、0.21 和 0.15。土耳其的土拉菌病于 1936 年首次在居住在色雷斯凯纳尔卡溪附近地区的士兵中报告。由于病例数量非常多，且遍布全国，这种疾病在土耳其近年来变得越来越重要。2005 年，土耳其共记录了 431 例土拉菌病病例，但随后三年病例数量显著减少；2008 年患者人数减少至 71 人。2009 年病例数再次增加，并持续到随后几年。2009 年、2010 年、2011 年和 2012 年，病例数分别达到 428 例、1531 例、2151 例和 607 例。2011 年，土耳其的病例数达到峰值，实际上高于所有欧盟国家的病例总数。在土耳其，女性的土拉菌病诊断病例数高于男性。在土耳其，52%的土拉菌病病例发生在 12 月至 3 月，最常见的临床症状是由受污染水引起的口咽型。在土耳其和科索沃，啮齿动物最有可能成为土拉菌病爆发的源头。蜱虫、苍蝇和蚊子等生物是土拉菌病向哺乳动物传播的媒介。由于蜱虫可以通过卵传和经代传播携带细菌，因此它们在土拉菌病的生命周期中既是储存宿主又是传播媒介。
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