In 2013, an oropharyngeal tularemia outbreak in Turkey affected 55 persons. Drinking tap water during the likely exposure period was significantly associated with illness (attack rate 27% vs. 11% among non-tap water drinkers). Findings showed the tap water source had been contaminated by surface water, and the chlorination device malfunctioned.
Keywords: Francisella tularensis subspecies holarctica; Tularemia; Turkey; bacteria; cohort studies; contamination; epizootic disease; exposure period; intracellular coccobacilli; oropharyngeal tularemia; outbreak; source; tap water; transmission; water.