RESUMO
BACKGROUND: Tularemia can become a health problem after its recent emergence in Spain. OBJECTIVE: To describe the clinico-epidemiologic characteristics of a tularemia outbreak occurred in Palencia (October 1997 to March 1998). DESIGN: Case-control study. MATERIAL AND METHODS: A clinico-epidemiologic survey was conducted. The Chi square test and the Student "t" test were used and a logistic regression analysis was made. The diagnosis was made by serology (microagglutination or macroagglutination) or culture. RESULTS: There were 151 cases; 74.5% of cases were confirmed or likely. The ulceroglandular was the most common clinical form of the disease (49%) and 23.2% of patients required hospital admission; 93.4% of patients had exposure to hares, and 86.7% of them handled them. Higher risk practices included skinning (adjusted OR: 3.9; 95% CI [1.03-14.7]; p = 0.04) and cutting/cooking (adjusted OR: 2.7; 95% CI [1.01-6.7]; p = 0.03). Streptomycin therapy was used for 51.6% of cases. CONCLUSIONS: The clinico-epidemiologic surveillance of this disease in Spain is necessary.