Tularemia in two South Dakota children

Tularemia may be relatively rare in the United States, but physicians must be able to recognize it in order to treat it in its earliest stages. They also need to understand that most antibiotics are not effective against the disease. This article presents two cases oftularemia infection among school-aged children in South Dakota who were successfully treated with IV gentamicin and oral antibiotic combinations.     

Landscape Epidemiology of Tularemia Outbreaks in Sweden

Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km², indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients’ statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks.     

Teleradiology in Croatia

A teleradiology system connecting 35 workstations in 27 hospitals was established in Croatia. In two years of operation, 2071 consultations were conducted using the system at an average rate of four neurosurgical teleconsultations per day. Eighty patients required urgent transfer to the tertiary hospital and 181 required non-urgent transfer. An additional 181 patients remained in their local hospital and were treated under the supervision of the tertiary hospital. The avoidance of unnecessary patient transfer led to significant cost savings.     

西藏地区土拉弗氏菌病初步调查

国内对土拉弗氏菌病(以下称本病)自然疫源地的调査材料尚未见到^[1]。     

Treatment of Tularemia in Pregnant Woman,France

A pregnant woman who had oropharyngeal tularemia underwent treatment with azithromycin and lymph node resection and recovered without obstetrical complication or infection in the child. Azithromycin represents a first-line treatment option for tularemia during pregnancy in regions where the infecting strains of Francisella tularensis have no natural resistance to macrolides.     

Health-risk behaviour in Croatia

OBJECTIVE: To identify the health-risk behaviour of various homogeneous clusters of individuals. STUDY DESIGN: The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. METHODS: The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. RESULTS: Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. CONCLUSION: Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations.