Unusual increase in tularemia incidence in Alsace, Northeastern France in 2024

IF 3.4 2区医学 Q2 INFECTIOUS DISEASES

Ticks and Tick-borne Diseases Pub Date : 2025-09-01 DOI:10.1016/j.ttbdis.2025.102545

M. Martinot , T. Lemmet , A. Barthel , P. Suntharasarma , M. Mohseni-Zadeh , G. Gregorowicz , P. Boyer , Y. Hansmann , V. Gerber

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引用次数: 0

Abstract

Tularemia is a bacterial zoonosis endemic to the Northern Hemisphere, transmitted through various modes and presenting with diverse clinical manifestations. In recent years, the number of notifications (tularemia is a reportable disease in France) have increased and the spectrum of clinical forms have changed. We conducted a retrospective study of tularemia incidence diagnosed in 2024 at two major hospitals in Alsace, a small region of Northeastern France. This study included 10 cases (7 men and 3 women; mean age = 52 years) reported in 2024. Clinical forms comprised six ulceroglandular or glandular cases, two oropharyngeal forms, and two pleuropulmonary forms including a fatal case in a 73-year-old immunocompromised patient.. Three patients reported recent tick bites, while two others had frequent tick exposure. In 9 of the 10 cases, tularemia was not initially suspected by primary care physicians, leading to delayed diagnosis, inappropriate treatment, and complications. Nationwide, 150 cases were reported in 2024, including 33 from the Northeastern region, of which 10 were our cases. Compared to other regions of France, cases in Alsace showed a higher proportion associated with tick-related transmission. Our findings reveal a peak in tularemia incidence in Alsace in 2024. Primary care physicians often failed to recognize tularemia, resulting in delayed treatment and complications—even in cases with typical glandular forms. Tularemia is an increasing zoonosis that may be under recognized among general practitioners. There is a need for increased awareness and education among healthcare providers and the public.

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2024年法国东北部阿尔萨斯地区兔热病发病率异常增加

土拉菌病是北半球特有的一种细菌性人畜共患病，通过多种方式传播，具有多种临床表现。近年来，通报的数量有所增加（土拉菌病在法国是一种需报告的疾病），临床形式的范围也发生了变化。我们对2024年在法国东北部小地区阿尔萨斯的两家主要医院诊断的兔热病发病率进行了回顾性研究。本研究纳入了2024年报告的10例病例（7男3女，平均年龄52岁）。临床形式包括6例腺或腺溃疡病例，2例口咽溃疡病例和2例胸膜肺溃疡病例，其中包括一名73岁免疫功能低下患者的致命病例。三名患者报告最近被蜱虫叮咬，另外两人经常接触蜱虫。在10例中，有9例最初未被初级保健医生怀疑为土拉菌病，导致诊断延误、治疗不当和并发症。2024年全国报告病例150例，其中东北地区33例，我市报告病例10例。与法国其他地区相比，阿尔萨斯的病例与蜱虫相关传播的比例更高。我们的研究结果显示，2024年阿尔萨斯地区兔热病发病率达到高峰。初级保健医生往往不能识别土拉菌病，导致治疗延误和并发症-即使是典型的腺状病例。兔热病是一种日益增加的人畜共患病，可能在全科医生中被认识不足。有必要提高卫生保健提供者和公众的认识和教育。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ticks and Tick-borne Diseases INFECTIOUS DISEASES-MICROBIOLOGY

CiteScore

6.90

自引率

12.50%

发文量

185

审稿时长

6-12 weeks

期刊介绍： Ticks and Tick-borne Diseases is an international, peer-reviewed scientific journal. It publishes original research papers, short communications, state-of-the-art mini-reviews, letters to the editor, clinical-case studies, announcements of pertinent international meetings, and editorials. The journal covers a broad spectrum and brings together various disciplines, for example, zoology, microbiology, molecular biology, genetics, mathematical modelling, veterinary and human medicine. Multidisciplinary approaches and the use of conventional and novel methods/methodologies (in the field and in the laboratory) are crucial for deeper understanding of the natural processes and human behaviour/activities that result in human or animal diseases and in economic effects of ticks and tick-borne pathogens. Such understanding is essential for management of tick populations and tick-borne diseases in an effective and environmentally acceptable manner.