A waterborne tularemia outbreak in eastern of Turkiye: Evaluation of Adult and Pediatric patients

Purpose Tularemia is a zoonotic disease that can cause outbreaks as well as sporadic cases. This study assessed to analyze patients identified in a waterborne tuaremia outbreak in a village in eastern Turkiye and to evaluate the adult and pediatric populations. Methods The study included patients who presented to the Infectious Diseases and Clinical Microbiology and Pediatrics outpatient clinics of Malazgirt State Hospital during the tularemia outbreak in January and February 2025 and were diagnosed with tularemia. Data on age, gender, clinical and laboratory findings, antibiotic regimens and durations, and complications were collected and analyzed. Results The study included 56 participants (mean age 24.6 ± 20.5 years, 44% female, 51% adult). No significant difference was found in the distribution of tularemia type between adult and pediatric patients (p = 0.198); the predominant type in both groups was the oropharyngeal form. Lymphadenopathy (LAP) was more frequent in adult patients (p < 0.05), abdominal pain was more frequent in pediatric patients (p < 0.001), and no significant differences were found in other clinical findings. Leukocytosis was significantly more frequent in pediatric patients compared to adults (p = 0.016). Treatment duration was statistically significantly longer in adult patients compared to pediatric patients (p < 0.001). One of the patients was pregnant who was treated with azithromycin and a healthy delivery was achieved. There were no cases resulting in sepsis or death. Conclusions Waterborne tularemia outbreaks can have different outcomes in different patient populations despite sharing a common causative pathogen. Therefore, individual patient assessments can be beneficial when managing an epidemic.