Los Angeles County West Vector & Vector-Borne Disease Control District

Tularemia

What is Tularemia?

    First described in Japan in 1837, tularemia is an infectious disease caused bytulare3.jpg (4726 bytes) the gram-negative pleomorphic bacterium, Francisella tularensis. The disease name relates to the description in 1911 of a plague like illness in ground squirrels in Tulare county, California and the subsequent work performed by Dr. Edward Francis.  Tularemia is sometimes called rabbit fever.
    F. tularensis is found worldwide in over 100 species of wild animals, birds, and insects. It produces an acute febrile illness in humans. The route of transmission and factors relating to the host and the organism influences presentation.

Frequency:
In the US: A few hundred cases of tularemia are reported annually in the US. As with most such diseases, the majority of cases are likely unreported or misdiagnosed. While sporadic cases occur in all states, those with highest prevalence are Arkansas, Illinois, Missouri, Texas, Oklahoma, Utah, Virginia, and Tennessee.
Frequency of tularemia has dropped markedly over the last 50 years and a shift from winter disease (usually from rabbits) to summer disease (more likely from ticks) has occurred.
Internationally: Tularemia is found worldwide, but incidence is unknown.

Who gets tularemia?
   
Hunters or other people who spend a great deal of time out of doors are at a greater risk of exposure to tularemia than people with other occupational or recreational interests.

How is tularemia spread?
   
Many routes of human exposure to the tularemia germ are known to exist. The common routes include: inoculation of the skin or mucous membranes with blood or tissue while handling infected animals; contact with fluids from infected flies or ticks; or handling or eating insufficiently cooked rabbit meat. Less common means of spread are: drinking contaminated water; inhaling dust from contaminated soil; or handling contaminated pelts or paws of animals.

What are the symptoms of tularemia?
   
Tularemia is usually recognized by the presence of a lesion and swollen glands. Ingestion of the organism may produce a throat infection, intestinal pain, diarrhea and vomiting. Inhalation of the organism may produce a fever alone or combined with a pneumonia-like illness.

How soon do symptoms appear?
   
Symptoms generally appear between two and 10 days, but usually after three days.

What is the treatment for tularemia?
   
Certain antibiotics such as streptomycin are effective in treating tularemia. Others such as gentamicin and tobramycin have also been reported to be effective.

Does past infection with tularemia make a person immune?
   
Long term immunity will follow recovery from tularemia, however, reinfection has been reported.

What can be done to prevent the spread of tularemia?
   
Rubber gloves should be worn when skinning or handling animals, especially rabbits. Wild rabbit and rodent meat should be cooked thoroughly before eating. Avoid bites of flies, mosquitoes and ticks and avoid drinking, bathing, swimming or working in untreated water.

How Can Tick Borne Illnesses be Prevented?

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