Risk factors associated with the frequency of antibodies to Francisella tularensis in two areas from Turkey

Year 2019, Volume: 49 Issue: 3, 137 - 141, 01.12.2019

Zeynep Özgen Özdemir Turabi Güneş Özlem Oyardı

Abstract

Francisella tularensis is a zoonotic microorganism that can infect different species of animals and sometimes humans. The
aim of this study was to determine the seroprevalence of F. tularensis in people from two areas in Turkey (Sivas and Tokat).
This is a retrospective study of the serum samples collected in 2006 from people living in rural areas (n:360) and from people
living in urban areas (n:90). F. tularensis-IgG antibodies were investigated by ELISA method. Antibody positivity against F.
tularensis was found in 7.5% of 360 serum collected from rural areas and 1.1% of 90 serum collected from urban areas (OR
7.216, 95% CI 0.967-53.836, p=0.025). While there was no difference in F. tularensis seropositivity between different genders
(p=0.424), tick contacts (p=0.303) and occupational groups (p=0.807), F. tularensis seropositivity was found to be higher in the
Tokat region than in the Sivas region (p=0.047). Moreover, risk factors were observed in people over 40 years of age (p=0.045)
and in those who consume fresh cheese (p=0.036). Our findings revealed that tularemia cases can be seen in these regions
even though tick bite cases in the Sivas and Tokat regions were not an important influence on the transmission of F. tularensis
to humans on the dates of our research.

Cite this article as: Özdemir ZÖ, Güneş T, Oyardı Ö (2019). Risk factors associated with the frequency of antibodies to Francisella tularensis in two areas from Turkey. Istanbul J Pharm 49 (3): 137-141.

Keywords

Francisella tularensis, tick bite, tularemia, Turkey

References

• Behan KA, Klein GC (1982). Reduction of Brucella species and Francisella tularensis cross-reacting agglutinins by dithiothreitol. J Clin Microbiol 16: 756-757. • Clark DV, Ismailov A, Seyidova E, Hajiyeva A, Bakhishova S, Hajiyev H, Hepburn MJ (2012). Seroprevalence of tularemia in rural Azerbaijan. Vector Borne Zoonotic Dis (Larchmont, N.Y.), 12: 558-563. • Dedeoğlu Kilinç G, Gürcan S, Eskiocak M, Kiliç H, Kunduracilar H (2007). Investigation of tularemia seroprevalence in the rural area of Thrace region in Turkey. Mikrobiyol Bul 41: 411-418. • Duzlu O, Yildirim A, Inci A, Gumussoy KS, Ciloglu A, Onder Z (2016). Molecular investigation of Francisella-like endosymbiont in ticks and Francisella tularensis in ixodid ticks and mosquitoes in Turkey. Vector Borne Zoonotic Dis 16: 26-32. • Ellis J, Oyston PCF, Green M, Titball RW (2002). Tularemia. Clin Microbiol Rev 15: 631-646. • Esmaeili S, Gooya MM, Shirzadi MR, Esfandiari B, Amiri FB, Behzadi MY, Mostafavi E (2014). Seroepidemiological survey of tularemia among different groups in western Iran. Int J Infect Dis IJID 18: 27-31. • Genchi M, Prati P, Vicari N, Manfredini A, Sacchi L, Clementi E, Bandi C, Epis S, Fabbi M (2015). Francisella tularensis: No evidence for transovarial transmission in the tularemia tick vectors Dermacentor reticulatus and Ixodes ricinus. PLoS One 10: e0133593. • Gunes T, Poyraz O, Mehmet A, Turgut NH (2012). The seroprevalence of Rickettsia conorii in humans living in villages of Tokat Province in Turkey, where Crimean-Congo hemorrhagic fever virus is endemic, and epidemiological similarities of both infectious agents. Turk J Med Sci 42: 441-448. • Gutiérrez MP, Bratos MA, Garrote JI, Dueñas A, Almaraz A, Alamo R, Rodríguez Marcos H, Rodríguez Recio MJ, Muñoz MF, Orduña A, Rodríguez-Torres A (2003). Serologic evidence of human infection by Francisella tularensis in the population of Castilla y León (Spain) prior to 1997. FEMS Immunol Med Microbiol 35:165-169. • Gürcan Ş (2014). Epidemiology of tularemia. Balk Med J 2014: 3-10. • Hestvik G, Warns-Petit E, Smith LA, Fox NJ, Uhlhorn H, Artois M, Gavier-Widen D (2015). The status of tularemia in Europe in a one-health context: a review. Epidemiol Infect 143: 2137-2160. • Jenzora A, Jansen A, Ranisch H, Lierz M, Wichmann O, Grunow R (2008). Seroprevalence study of Francisella tularensis among hunters in Germany. FEMS Immunol Med Microbiol 53: 183-189. • Karasartova D, Gureser AS, Gokce T, Celebi B, Yapar D, Keskin A, Taylan-Ozkan A (2018). Bacterial and protozoal pathogens found in ticks collected from humans in Corum province of Turkey. PLoS Negl Trop Dis 12: e0006395. • Kilic S, Birdsell DN, Karagöz A, Çelebi B, Bakkaloglu Z, Arikan M, et al. (2015). Water as source of Francisella tularensis infection in humans, Turkey. Emerg Infect Dis 21: 2213. • Koskela P, Salminen A (1985). Humoral immunity against Francisella tularensis after natural infection. J Clin Microbiol 22: 973-979. • Leblebicioglu H, Esen S, Turan D, Tanyeri Y, Karadenizli A, Ziyagil F, Goral G (2008). Outbreak of tularemia: a case– control study and environmental investigation in Turkey. Int J Infect Dis 12: 265-269. • Maurin M, Gyuranecz M (2016). Tularaemia: clinical aspects in Europe. Lancet Infect Dis 16: 113-124. • Milutinović M, Masuzawa T, Tomanović S, Radulović Z, Fukui T, Okamoto Y (2008). Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Francisella tularensis and their co-infections in host-seeking Ixodes ricinus ticks collected in Serbia. Exp Appl Acarol 45: 171-183. • Porsch-Ozcürümez M, Kischel N, Priebe H, Splettstösser W, Finke E-J, Grunow R (2004). Comparison of enzyme-linked immunosorbent assay, Western blotting, microagglutination, indirect immunofluorescence assay, and flow cytometry for serological diagnosis of tularemia. Clin Diagn Lab Immunol 11: 1008-1015. • Reye AL, Hübschen JM, Sausy A, Muller CP (2010). Prevalence and seasonality of tick-borne pathogens in questing Ixodes ricinus ticks from Luxembourg. Appl Environ Microbiol 76: 2923-2931. • Socolovschi C, Mediannikov O, Raoult D, Parola P (2009). Update on tick-borne bacterial diseases in Europe. Parasite 16: 259-273. • Ulu-Kilic A, Doganay M (2014). An overview: tularemia and travel medicine. Travel Med Infect Di 12: 609-616. • Zellner B, Huntley JF (2019). Ticks and Tularemia: Do We Know What We Don’t Know? Front Cell Infect Microbiol 9: 146.