Tularemia outbreaks in türkiye, epidemiological features and comparison of tularemia forms seen in outbreaks

Tularemia is a zoonotic infectious disease characterized primarily by waterborne outbreaks. This study aims to provide an epidemiological analysis of tularemia outbreaks reported in Türkiye from past to present. By examining the dates, geographical distribution, number of cases, routes of transmission, clinical forms, environmental risk factors, causes of outbreaks, and control measures, it aims to be prepared for a source-containment approach for future tularemia infections. Epidemiological reports and field studies found in the literature via electronic article search systems Pubmed, Google Scholar, TÜBİTAK ULAKBİM, online books, publications, and field guides were reviewed, and case numbers, clinical forms, and possible sources of transmission were analyzed. The study revealed that hundreds of cases were reported in tularemia outbreaks that occurred in various regions between 1936 and 2025. It was determined that the most common modes of transmission in Türkiye were contaminated water and vector contact, and that the oropharyngeal form was the most common among clinical forms. Outbreaks generally occurred during periods of increased rodent populations, contamination of water sources, and inadequate sanitation. Tularemia continues to pose a public health risk in Türkiye Because tularemia is a zoonotic infectious disease characterized by waterborne outbreaks, controlling contaminated water, rodents, and vectors, and ensuring water sanitation are critical to preventing outbreaks. Furthermore, strengthening early diagnosis capacity through regular epidemiological surveillance is crucial for preventing outbreaks. Keywords: Epidemiology, outbreak, sanitation, tularemia, zoonotic.