%0 Journal Article %A Willke, A. %A Meric, M. %A Grunow, R. %A Sayan, M. %A Finke, E. J. %A Splettstößer, W. %A Seibold, E. %A Erdoğan, S. %A Ergonul, O. %A Yumuk, Z. %A Gedikoglu, S. %T An outbreak of oropharyngeal tularaemia linked to natural spring water %D 2009 %J Journal of Medical Microbiology, %V 58 %N 1 %P 112-116 %@ 1473-5644 %R https://doi.org/10.1099/jmm.0.002279-0 %K MAT, microagglutination test %I Microbiology Society, %X 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 MAT-negative 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 (P=0.0001, odds ratio 0.165, 95 % CI 0.790–0.346). The outbreak ceased after abandonment of the suspected natural water springs. %U https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.002279-0