Introduction: Tularemia is a zoonotic disease caused by the gram-negative bacteria Francisella tularensis. It manifests in several forms depending on the infection site. Mainly, these are ulceroglandular, glandular, and pneumonic types. Tularemia has a long history in Georgia, with monitoring efforts initiated after its first recorded case in 1946. Human outbreaks have been documented across various regions, with notable increases in cases over recent decades, emphasizing the importance of enhancing surveillance and preparedness efforts. In this study, we will review a sudden increase in tularemia cases in Georgia in 2023. Methods: Tularemia is classified as an especially dangerous pathogen and requires immediate reporting. Data was extracted through the Electronic Integrated Disease Surveillance System (EIDSS). Probable tularemia cases were patients with compatible clinical manifestations and a positive micro-agglutination test (MAT). Results: In the period of 2018-2022, 1 or 2 confirmed cases of tularemia were registered per year in EIDSS. However, in 2023, a total of 16 confirmed cases of tularemia were registered. Out of the total, 56.2% were male, and 43.8% - female. The mean age of the cases was 49 years. In 68.8% of cases, ulceloglandular, in 18.7% - glandular, and in 12.5% - pneumonic types were registered. All confirmed cases were registered in the eastern part of the country. The majority of cases were registered in the spring, summer, and autumn seasons (93.8%). Conclusion: The sudden increase in tularemia cases in Georgia in 2023 underscores the need for heightened surveillance and response measures. With the majority of cases presenting as the ulceroglandular type and occurring in the eastern regions during warmer months, targeted interventions and public health initiatives are essential. This rise in cases, alongside tularemia’s classification as a bioterrorism threat, emphasizes the importance of robust surveillance, timely diagnosis, and effective disease control strategies to mitigate future outbreaks.
Chakhunashvili et al. (Sun,) studied this question.