RESUMEN
STUDY OBJECTIVE: Analysis of epidemiological trends in tularemia in the Slovak Republic (SR) over the last 12 years and changes in the epidemiology of this infection. MATERIAL AND METHODS: The sources of data for the epidemiological analysis are the SR annual tularemia surveillance report, records of epidemiological investigation of reported cases and knowledge from long-term surveillance of natural foci. The incidence of tularemia was analyzed based on the standard epidemiological indicators and in relation to infection sources and transmission routes. RESULTS: In 1997-2008, a total of 453 tularemia cases were reported from all administrative regions in Slovakia, the mean incidence was 0.71/10(5) population and 95.4% of cases were reported in the West, with the predominance of cases in the Nitra region where the mean incidence was 4/10(5) population. In the outbreak of 2002, the incidence of tularemia was as high as 18 cases/10(5) population. Tularemia cases were reported in all age groups and more than half of the patients were aged between 30 to 59 years. Tularemia cases were 1.9 times more frequent in males than in females. The seasonal trend peaked in summer, month of July. In a greater proportion of cases, 58.5%, the source of infection was other than brown hares, 16.3%, which correlates well with the decrease in the hare tularemia foci in the study period. The most frequent route of transmission was work exposure to contaminated animal feed and bedding and in an dusty environment with increased occurrence of small rodents. The proportion of tick-borne and biting insect-borne cases was 12.8% and 12.4% of cases were not elucidated epidemiologically. Clinical manifestations were ulceroglandular and glandular tularemia in 55.6%, pulmonary tularemia in 21.2 %, oroglandular tularaemia in 18.8% and other forms of tularaemia in 4.4%. CONCLUSION: The changes in the distribution of sources of infection and routes of transmission resulted in changed epidemiological characteristics and clinical forms of tularemia in Slovakia. The importance of tularemia surveillance is underlined.
Asunto(s)
Tularemia/epidemiología , Adulto , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Estaciones del Año , Eslovaquia/epidemiologíaRESUMEN
The activation of natural foci of tularaemia in West Slovakia during 1994-1996 led to an epidemic outbreak in 1995-1996--mean annual morbidity 6.2 per 10(5) population. In comparison with the mean annual morbidity rate in the preceding period (1980-1994), a more than sevenfold increase was recorded. Of 213 notified cases of the disease 156 cases occurred in 1995--morbidity 8.9 per 10(5) population--being the highest morbidity recorded in this endemic region since the period of epidemic occurrence in the 60s. The highest proportion of cases (59.2%) was recorded in the districts of Nitra and Nové Zámky. The activation of natural foci along with changing social conditions, caused also marked changes of some epidemiological characteristics of tularaemia in Slovakia, such as seasonal and professional occurrence, as well as clinical forms of the disease. The impaired epidemiological situation in the occurrence of tularaemia is pointing to the importance of systematic surveillance to improve the diagnosis of the disease and ensure effective preventive measures.