Tularemia is a rare infectious disease that can attack the skin, eyes, lymph nodes, lungs and, less often, other internal organs. Often called rabbit fever or deer fly fever, tularemia is caused by the bacterium Francisella tularensis. The disease mainly affects mammals, especially rodents, rabbits and hares, although it can also infect birds, reptiles and fish.
Tularemia spreads to humans through several routes, including insect bites and direct exposure to an infected animal. Highly contagious and potentially fatal, tularemia usually can be treated effectively with specific antibiotics if diagnosed early.
Most people exposed to tularemia who become sick generally do so within two to 10 days. Several types of tularemia exist, and which type you get depends on how and where the bacteria enter the body. Most commonly, they enter through skin or mucous membranes, but they can also be inhaled or eaten. Each type of tularemia has its own set of symptoms.
Other forms of tularemia also can spread to the lungs.
When to see a doctor
Tularemia doesn't occur naturally in humans and isn't known to pass from person to person. However, tularemia occurs worldwide, especially in rural areas, because many mammals, birds, insects and fish are infected with F. tularensis. The organism can live for weeks in soil, water and dead animals.
Unlike some infectious diseases that spread from animals to people through a single route, tularemia has several modes of transmission. How you get the disease usually determines the type and severity of symptoms. In general, you can get tularemia through:
Although anyone of any age can develop tularemia, engaging in certain occupations or activities or living in certain areas pose a greater risk.
Living in or visiting certain areas
Having certain hobbies or occupations
Left untreated, tularemia can be fatal. Other possible complications include:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to an infectious diseases specialist.
Here's information to help you prepare for your appointment.
What you can do
Preparing a list of questions for your doctor will help you make the most of your time together. List your questions from most important to least important. For tularemia, some basic questions to ask your doctor include:
Don't hesitate to ask any other relevant questions you have.
What to expect from your doctor
Tests and diagnosis
Because it's rare and because it shares symptoms with other diseases, tularemia may be difficult to diagnose. Doctors may check for F. tularensis in a blood or sputum sample that's cultured to encourage the growth of the bacteria. But the preferred way to diagnose tularemia usually is to identify antibodies to the bacteria in a sample of blood. You're also likely to have a chest X-ray to look for signs of pneumonia.
Treatments and drugs
Tularemia can be effectively treated with antibiotics such as streptomycin or gentamicin, which are given by injection directly into a muscle or vein. Depending on the type of tularemia being treated, doctors may prescribe oral antibiotics such as doxycycline (Oracea, Vibramycin, others) instead.
You'll also receive therapy for any complications such as meningitis or pneumonia. In general, you should be immune to tularemia after recovering from the disease, but some people may experience a recurrence or reinfection.
Attempts to develop a tularemia vaccine have not been successful so far. If you work in a high-risk occupation or live in an area where tularemia is present, these measures may help reduce your chance of infection:
Last Updated: 2012-08-30
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