Tularemia
Deerfly fever; Rabbit fever; Pahvant Valley plague; Ohara disease; Yato-byo (Japan); Lemming feverTularemia is a bacterial infection in wild rodents. The bacteria are passed to humans through contact with tissue from the infected animal. The bacteria can also be passed by ticks, biting flies, and mosquitoes.
Ticks
Ticks are bugs that can attach to you as you brush past bushes, plants, and grass. Once on you, ticks often move to a warm, moist place on your body...
Read Article Now Book Mark ArticleCauses
Tularemia is caused by the bacterium Francisella tularensis.
Humans can get the disease through:
- A bite from an infected tick, horsefly, or mosquito
- Breathing in infected dirt or plant material
- Direct contact, through a break in the skin, with an infected animal or its dead body (most often a rabbit, muskrat, beaver, or squirrel)
- Eating infected meat (rare)
The disorder most commonly occurs in North America and parts of Europe and Asia. In the United States, this disease is found more often in Missouri, South Dakota, Oklahoma, and Arkansas. Although outbreaks can occur in the United States, they are rare.
Some people may develop pneumonia after breathing in infected dirt or plant material. This infection has been known to occur on Martha's Vineyard (Massachusetts), where bacteria are present in rabbits, raccoons, and skunks.
Pneumonia
Pneumonia is inflamed or swollen lung tissue due to infection with a germ. With atypical pneumonia, the infection is caused by different bacteria tha...
Read Article Now Book Mark ArticleSymptoms
Symptoms develop 3 to 5 days after exposure. The illness usually starts suddenly. It may continue for several weeks after symptoms begin.
Symptoms include:
- Fever, chills, sweating
- Eye irritation (called conjunctivitis, if the infection began in the eye)
Conjunctivitis
The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Conjunctivitis occurs when the conjunctiva becomes ...
Read Article Now Book Mark Article - Headache
- Joint stiffness, muscle pain
- Red spot on the skin, growing to become a sore (ulcer)
- Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Weight loss
Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
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Exams and Tests
Tests for the condition include:
- Blood culture for the bacteria
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Read Article Now Book Mark Article - Blood test measuring the body's immune response (antibodies) to the infection (serology for tularemia)
Serology for tularemia
Tularemia blood test checks for infection caused by bacteria called Francisella tularensis (F tularensis). The bacteria causes the disease tularemia...
Read Article Now Book Mark Article - Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark Article - Polymerase chain reaction (PCR) test of a sample from an ulcer
Treatment
The goal of treatment is to cure the infection with antibiotics.
The antibiotics streptomycin and tetracycline are commonly used to treat this infection. Another antibiotic, gentamicin, has been tried as an alternative to streptomycin. Gentamicin seems to be very effective, but it has been studied in only a small number of people because this is a rare disease. The antibiotics tetracycline and chloramphenicol can be used alone but are not usually a first choice.
Outlook (Prognosis)
Tularemia is fatal in about 5% of untreated cases, and in less than 1% of treated cases.
Possible Complications
Tularemia may lead to these complications:
- Bone infection (osteomyelitis)
Osteomyelitis
Osteomyelitis is a bone infection. It is caused by bacteria or other germs.
Read Article Now Book Mark Article - Infection of the sac around the heart (pericarditis)
Pericarditis
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
Read Article Now Book Mark Article - Infection of the membranes covering the brain and spinal cord (meningitis)
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Read Article Now Book Mark Article - Pneumonia
When to Contact a Medical Professional
Contact your health care provider if symptoms develop after a rodent bite, tick bite, or exposure to the flesh of a wild animal.
Prevention
Preventive measures include wearing gloves when skinning or dressing wild animals and staying away from sick or dead animals.
References
Auwaerter PG, Penn RL. Francisella tularensis (tularemia). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 227.
Bloch KC, Schaffner W. Tularemia and other Francisella infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 295.
Deer ticks - illustration
Diseases are often carried by ticks, including Rocky Mountain Spotted Fever, Colorado Tick Fever, Lyme disease, and tularemia. Less common or less frequent diseases include typhus, Q-fever, relapsing fever, viral encephalitis, hemorrhagic fever, and babesiosis.
Deer ticks
illustration
Ticks - illustration
There are many species of ticks. Of these, a large proportion are capable of carrying disease. Diseases carried by ticks include Lyme disease, Ehrlichiosis, Rocky Mountain Spotted Fever, Colorado Tick Fever, tularemia, typhus, hemorrhagic fever, and viral encephalitis. (Image courtesy of the Centers for Disease Control and Prevention.)
Ticks
illustration
Tick imbedded in the skin - illustration
This is a close-up photograph of a tick embedded in the skin. Ticks are important because they can carry diseases such as Rocky Mountain spotted fever, tularemia, Colorado tick fever, Lyme disease, and others.
Tick imbedded in the skin
illustration
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Bacteria - illustration
Bacterial infections can lead to the formation of pus, or to the spread of the bacteria in the blood.
Bacteria
illustration
Deer ticks - illustration
Diseases are often carried by ticks, including Rocky Mountain Spotted Fever, Colorado Tick Fever, Lyme disease, and tularemia. Less common or less frequent diseases include typhus, Q-fever, relapsing fever, viral encephalitis, hemorrhagic fever, and babesiosis.
Deer ticks
illustration
Ticks - illustration
There are many species of ticks. Of these, a large proportion are capable of carrying disease. Diseases carried by ticks include Lyme disease, Ehrlichiosis, Rocky Mountain Spotted Fever, Colorado Tick Fever, tularemia, typhus, hemorrhagic fever, and viral encephalitis. (Image courtesy of the Centers for Disease Control and Prevention.)
Ticks
illustration
Tick imbedded in the skin - illustration
This is a close-up photograph of a tick embedded in the skin. Ticks are important because they can carry diseases such as Rocky Mountain spotted fever, tularemia, Colorado tick fever, Lyme disease, and others.
Tick imbedded in the skin
illustration
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Bacteria - illustration
Bacterial infections can lead to the formation of pus, or to the spread of the bacteria in the blood.
Bacteria
illustration
Review Date: 2/11/2023
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.