An infection common in wild rodents that is passed to humans through contact with infected animal tissues or by ticks, biting flies, and mosquitoes.
Also known as rabbit, fever, hunters, disease, and deer fever.
A zoonotic caused by the fastidious gram-negative bacterium Francisella tularensis.
Humans acquire the disease by a number of ways including: a bite from an infected tick, horsefly, or mosquito, breathing in infected dirt or plant material, direct contact of the skin, with an infected animal or its dead body, most often a rabbit, muskrat, beaver, or squirrel and rarely eating infected meat.
The disorder most commonly occurs in North America and parts of Europe and Asia.
F. tularensis distributed throughout Northern Hemisphere.
F. tularensis is in aerobic, facultative, intracellular, gram-negative coccobacillus.
Tularemia is most prevalent in south central and western states.
Most infections result from cutaneous inoculations associated with tick bites with direct contact with rabbits and hares, rodents or cats.
Contaminated water or inhalation aerosol bacteria can cause human disease.
Airborne infections can result from exposure to agricultural dust and from landscaping activities that could result from aerosolized infected animal tissues and excreta.
Rare outbreaks can occur in the United States.
Patients may develop pneumonia after breathing in infected dirt or plant material.
Francisella tularensis is considered a potential bioterrorism agent.
Highly infectious, as few as 10 bacteria can cause human disease by cutaneous or respiratory routes.
The pathogenic agent has the capacity to invade and suppress innate immune responses as it replicates within host cells.
Incubation period is 3 to 5 days after exposure.
The illness usually starts suddenly, and may continue for several weeks after symptoms begin.
Symptoms include: chills, fevers, headache, arthralgias, myalgias, skin ulcer, conjunctivitis, dyspnea, diaphoresis, and weight loss.
Tularemia manifests in six clinical syndrome: ulceroglandular, glandular, oculoglandular, oropharyngeal and typhoidal.
Ulceroglandular is the most common manifestation, but typhoid syndrome has the highest mortality.
Diagnosis relies on microbiologic tests with isolation of the organism in a clinical specimen or change in serum antibody titer by a factor of four or more between acute and convalescent serum specimens.
Treatment gentamicin.
Other agents that are effective include fluoroquinolones, or doxycycline
Tularemia is fatal in about 5% of untreated cases, and in less than 1% of treated cases.
Complications include osteomyelitis, pericarditis, meningitis, and pneumonia.