Although almost a century has gone by since its first description in the country, Turkey has not been able to eradicate brucellosis, which remains a major public health problem. In this review, we give an overview of the epidemiological and epizootic status of brucellosis in Turkey. Although little readily accessible data concerning the epidemiology of brucellosis in Turkey are available, the limited official and published data were analyzed. Despite being endemic in Turkey, brucellosis remains under-diagnosed and under-reported. Adherence to traditional farming practices and lifestyles and the consumption of fresh dairy produce contribute to the high incidence of brucellosis. The successful implementation of a national brucellosis control program requires strong political will, good funding, and collaboration, especially between the public health and veterinary sectors. Primary healthcare workers should always keep the symptoms of acute and chronic brucellosis in mind when treating patients.
A tularaemia outbreak was investigated involving 188 suspected cases in the Kocaeli region of Turkey between December 2004 and April 2005. A case-control study comprising 135 laboratory-confirmed cases and 55 controls was undertaken to identify risk factors for the development of the outbreak and to evaluate laboratory diagnostic methods. Tularaemia was confirmed by a microagglutination test (MAT) titre of ¢1 : 160 in 90 of the patients. In MATnegative sera, 23/44 (52 %) were positive by ELISA with Francisella tularensis LPS and 1/9 (11 %) by Western blotting with this antigen. A species-specific PCR was positive in 16/25 (64 %) throat swabs and 8/13 (62 %) lymph node aspirates. Multivariate analysis showed that drinking natural spring water was the leading risk factor for the development of tularaemia (P50.0001, odds ratio 0.165, 95 % CI 0.790-0.346). The outbreak ceased after abandonment of the suspected natural water springs.
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