1. Tularemia outbreak investigation in Kosovo: case control and environmental studies.
- Author
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Reintjes R, Dedushaj I, Gjini A, Jorgensen TR, Cotter B, Lieftucht A, D'Ancona F, Dennis DT, Kosoy MA, Mulliqi-Osmani G, Grunow R, Kalaveshi A, Gashi L, and Humolli I
- Subjects
- Adolescent, Adult, Aged, Animals, Case-Control Studies, Child, Child, Preschool, Female, Francisella tularensis isolation & purification, Humans, Hygiene, Infant, Lymphadenitis epidemiology, Lymphadenitis microbiology, Male, Middle Aged, Pharyngitis epidemiology, Pharyngitis microbiology, Risk Factors, Rodentia, Seroepidemiologic Studies, Tularemia transmission, Warfare, Water Microbiology, Yugoslavia epidemiology, Disease Outbreaks, Food Contamination analysis, Francisella tularensis pathogenicity, Tularemia epidemiology
- Abstract
A large outbreak of tularemia occurred in Kosovo in the early postwar period, 1999-2000. Epidemiologic and environmental investigations were conducted to identify sources of infection, modes of transmission, and household risk factors. Case and control status was verified by enzyme-linked immunosorbent assay, Western blot, and microagglutination assay. A total of 327 serologically confirmed cases of tularemia pharyngitis and cervical lymphadenitis were identified in 21 of 29 Kosovo municipalities. Matched analysis of 46 case households and 76 control households suggested that infection was transmitted through contaminated food or water and that the source of infection was rodents. Environmental circumstances in war-torn Kosovo led to epizootic rodent tularemia and its spread to resettled rural populations living under circumstances of substandard housing, hygiene, and sanitation.
- Published
- 2002