What is tularemia?

Tularemia, also known as "rabbit fever," is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits, and hares. 
Tularemia is a widespread disease in animals-especially rodents and rabbits-and about 200 human cases are reported each year in the United States. Most cases occur in the south-central and western states. Nearly all cases occur in rural areas, and are caused by the bites of ticks and biting flies or from handling infected sick or dead animals. Cases also resulted from inhaling airborne bacteria and from laboratory accidents.

Tularemia is highly infectious, and a very small number of bacteria can cause disease. If Francisella tularensis were used as a bioweapon, the bacteria would likely be made airborne so they could be inhaled. People who inhale the bacteria can experience severe respiratory illness, including life-threatening pneumonia, if they are not treated.

What are the symptoms of tularemia?

Symptoms of tularemia depend on how individuals are exposed to the disease. Possible symptoms include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia. If the bacteria are inhaled, patients may experience an abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough, and progressive weakness. Individuals with pneumonia can develop chest pain, difficulty breathing, bloody sputum, and respiratory failure. Individuals infected with tularemia may die if they're not treated with appropriate antibiotics.

Symptoms usually appear three to five days after infection, but the delay can reach up to two weeks. Tularemia is not known to be transmitted between humans, so sick individuals do not have to be isolated.

Individuals who feel they might have been exposed to tularemia should see a physician immediately. Healthcare workers can do tests by collecting blood or sputum and sending it to a laboratory for testing.  Preliminary identification takes less than two hours, but a definitive diagnosis usually takes 24 to 48 hours. Treatment may begin before laboratory results are returned.

How is tularemia treated?

Early antibiotic treatment is very important for individuals exposed to or diagnosed with tularemia. Several types of antibiotics have proven effective, including ciprofloxin and doxycyline oral medication and streptomycin and gentamicin injections. Health officials test a patient's bacteria in the early stages of tularemia to determine which antibiotics will be most effective.
A vaccine for tularemia was used in the past to protect laboratory workers, but it is not currently available.

If you suspect you were exposed to tularemia bacteria, see a doctor quickly. If you are given antibiotics, take all of them exactly as your doctor instructs.

To find out more about tularemia, check out the Centers for Disease Control web site, http://www.bt.cdc.gov/agent/tularemia/faq.asp, or ask your doctor.