Epidemiological analysis and subsbtantiation of risk areas and groups for tularemia in Altai (1939–2024)

Over 1939–2024, 2727 cases of human tularemia were registered in the Altai region. Considering epidemic manifestations of morbidity, as well as the dynamics of natural foci activity for the entire period of observation, we can distinguish three epidemiological periods for this nosology: the first, 1939–1968; the second, 1969–1999; and the third, 2000–2024. During the first 29 years after the pathogen registration started, 98.1 % of the cases (2676 people) were registered in Gorno-Altaisk and in eight districts of the Altai Republic, as well as in 44 districts and four cities of the Altai Krai. These districts were located mainly in the southwest of Altai on the border with Kazakhstan, as well as with the Novosibirsk and Kemerovo regions, which are bothendemic for this nosology. From 1947 to 1968, anginosis-bubonic (69.0 %) clinical form of tularemia was found to prevail. Intensified efforts to eliminate epidemic foci of tularemia infection together with widespread specific immune prophylaxis led to a decline in the number of registered disease cases among the local population from 1969 to 1999. Sporadic cases of tularemia among humans were noted only in 1988–1990, while tularemia microbe was still isolated from environmental objects. Over 2000–2024, 48 tularemia cases were registered in Altai. Anginosis-bubonic form of the disease was the most frequent accounting for 41.7 %. Unfavorable situation on tularemia was detected in 15 districts of the Altai region and in two cities, Barnaul and Gorno-Altaisk. Cases were registered in the same municipalities where tularemia occurred during outbreaks in 1939–1968. Retrospective analysis of tularemia incidence showed a decline in the number of cases from the first reported cases in 1939 to sporadic cases at present. More careful planning of risk groups prone to contacts with components of parasitocenosis forimplementing measures on specific and nonspecific prevention of tularemia will reduce the likelihood of epidemic complications as regards this infection and ensure the sanitary and epidemiological well-being of the population among residents and visitors of the region.