Tularemia Information

Tularemia, otherwise known as “rabbit fever” or “deer fly fever”, is a very contagious and possibly fatal disease caused by the bacteria Franciscella tularensis which can affect the skin, eyes, and lungs. It is transferred commonly by arthropods such as ticks or deer fly which are found usually in rabbits, deer, and some other rodents and mammals. It can also be acquired by drinking an infected water source. It is named after Tulare County in California, where a large number of squirrels died in 1911 during an outbreak of this disease. However, it was first described in Japan in 1837. The disease however, could be found all over the United States and in every season as well though it is not very widespread as fewer than 200 cases are reported each year. People usually become immune to tularemia after being exposed to it once, although there are cases where it has reinfected people. The mortality is about 5% for tularemia and with the application of antibiotic treatments it drops to about 1%.

Early symptoms of tularemia can include fever, chills and gradual weakness which may appear anytime between one to fourteen days after exposure to the bacteria. Depending on the site of infection, tularemia can have a wide range of symptoms such as skin ulcers, swollen lymph nodes in various places in the body, sore throat and conjunctivitis. Severe symptoms may include a high fever, low blood pressure, coughing which may expel blood, difficulty in breathing and fainting. Extreme cases may involve severe weakness and major weight loss. Complications of tularemia include pneumonia, pericarditis, meningitis and osteomyelitis.

Generally, tularemia is divided into 6 categories, depending on where the bacterium was contracted. These are the ulceroglandular, glandular, oculoglandular, oropharyngeal, pneumonic, and typhoidal tularemia. The ulceroglandular tulameria is the common mode of transmission where the pathogens are supposed to have entered the body through an abrasion on the skin – possibly and insect or tick bite from handling mammals such as rabbits or deer. Glandular tularemia is a rarer form of the diseases where it is not apparent where the abrasion is where the bacteria could have entered. Oculoglandular tularemia is caused by infected blood or water splashing into the eyes while oropharyngeal tularemia involves ingesting the bacteria orally, possibly from eating undercooked rabbit meat containing the bacteria. The bacteria may also be inhaled from infected soil, resulting in pneumonic tularemia, while the rarest and most deadly is the typhoidal tularemia, whose mode of transmission remains unknown. It may cause sepsis which can be immediately fatal for the patient.

Many insects and arthropods are known to be able to carry the bacteria, and these include ticks, mosquitoes, deer flies, horseflies and other biting arthropods. The bacteria can also be found in untreated water sources, in soil particles, and in the bodily fluids of infected mammals. These would traditionally involve rabbits, deer, voles, squirrels and other wild animals, but there are cases of pet hamsters and rabbits carrying tularemia. The animals may also transmit tularemia directly from their bites or scratches. The bacteria however, cannot be passed from one person to another.

Tularemia is easily acquired as only 10 microorganisms are needed to cause the disease in people and can easily be suspended in an aerosol. This has made tularemia a potential choice for use as a biological weapon.

Antibiotics such as Streptomycin are used to fight the infection of F tularensis and are administered intravenously. Oral antibiotics such as those part of the tetracycline and fluoroquinolone class are also effective against tularemia. An early test can be taken to find which antibiotic will be the most effective to deal with the individual strain of bacteria involved.

If a tick has bitten you and is currently latched on to your skin, do not use your bare hands to remove it. Use tweezers to firmly pull it out whole. Do not twist it nor use fire to burn it off. Do not cover it with petroleum jelly in an attempt to kill it. Make sure that you pull out the ticks mandibles out of the skin as well as these may cause infection if left there. You may want to keep the tick in a container with alcohol in order for the doctor to identify any diseases from the tick if any symptoms arise. See a doctor 4 hours after discovering the tick if you are unable to remove it from your skin.

Care should be taken when outdoors and dealing with wild animals. If possible refrain from going into the woods during tick season. If you must, wear long-sleeved clothing and pants, while tucking your pant legs in your socks to avoid insects and ticks getting inside. Apply insect repellent to discourage insect bites. Repellents containing DEET may be effective however, make sure to wash it off at the end of each day and avoid giving it to children below 2 years of age. Natural repellents such as lemon oil or eucalyptus can also work effectively. Wear rubber gloves and goggles to prevent contamination from the blood when handling carcasses. Avoid drinking from untreated water sources as these may also carry the bacteria. Do not eat undercooked meat from wild animals; make sure they are thoroughly cooked before eating them. Always wash your hands thoroughly after dealing with animals, dead or alive.

Keeps your pets clean and inspect them regularly for ticks and other insects which may hide in their bodies. Keep them away from dead or wild animals and do not let them wander out in the woods unsupervised.

Gardeners should also wear face masks when working on the soil to avoid inhaling the bacteria that may be found on the soil particles which may get stirred up in the air.

A live vaccine is available but not to the general public. Its use is primarily limited to lab technicians who regularly handle F tularensis and woodsmen and hunters who are at high risk of contracting tularemia.