Tularemia

 

 

What is tularemia?

Tularemia, also known as "rabbit fever," is an infectious disease caused by a hardy bacterium, Francisella tularensis. It is typically found in animals, especially rodents, rabbits, and hares. Tularemia is a rural disease and occurs in all states except Hawaii.

 

What are the signs and symptoms of tularemia?

Depending on the route of exposure, the tularemia bacteria may cause skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, oral ulcers, or pneumonia. Early symptoms almost always include the abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough, and progressive weakness. Persons with pneumonia can develop chest pain, difficulty breathing, bloody sputum, and respiratory failure. Some persons with the lung and systemic forms of the disease may die if they are not treated with appropriate antibiotics.

 

How do people become infected with the tularemia bacteria?

Typically, persons become infected through the bites of arthropods (most commonly, ticks and deerflies), by handling infected animal carcasses, by eating or drinking contaminated food or water, or by inhaling infected aerosols.

 

Does tularemia occur naturally in the United States?

Yes. Approximately 200 cases of tularemia in humans are reported annually in the United States, mostly in persons living in the south-central and western states. Nearly all cases occur in rural areas and are associated with the bites of infective ticks and flies or with the handling of infected rodents, rabbits, or hares. Occasional cases result from inhaling infectious aerosols and from laboratory accidents.


What should someone do if they suspect they or others have been exposed to the tularemia bacteria?

An individual is encouraged to seek prompt medical attention. If a person has been exposed to Francisella tularensis, treatment with antibiotics for 10-14 days or more after exposure may be recommended. 

Local and state health departments should be immediately notified in order to swiftly initiate an investigation and begin control activities.

 

How is tularemia diagnosed?

When tularemia is clinically suspected, the healthcare worker will collect specimens, such as blood or sputum, from the patient for testing in a diagnostic or reference laboratory. Laboratory test results for tularemia may be presumptive or confirmatory.

Presumptive (preliminary) identification may take less than 2 hours, but confirmatory testing will take longer, usually 24 to 48 hours but sometimes a week or more.

 

Can tularemia be effectively treated with antibiotics?

After potential exposure or diagnosis, early treatment is recommended with an antibiotic from the tetracycline (such as doxycycline) or fluoroquinolone (such as ciprofloxacin) class, which are taken orally, or the antibiotics streptomycin or gentamicin, which are given intramuscularly or intravenously.

 

How long can Francisella tularensis exist in the environment?

Francisella tularensis has the ability to remain alive in the water and soil for weeks at a time.

 

Is there a vaccine available for tularemia?

In the past, a vaccine for tularemia has been used to protect laboratory workers, but it is not currently available. 

 

Tularemia is considered a Category A disease/agent

Category A Diseases/Agents

The U.S. public health system and primary healthcare providers must be prepared to address various biological agents, including pathogens that are rarely seen in the United States. High-priority agents include organisms that pose a risk to national security because they

  • can be easily disseminated or transmitted from person to person;
  • result in high mortality rates and have the potential for major public health impact;
  • might cause public panic and social disruption; and
  • require special action for public health preparedness.

 

 Source: Centers for Disease Control and Prevention