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Tularemia

Alternate Names

  • rabbit fever

Definition

Tularemia is disease caused by a bacterial infection that is transmitted to humans from an infected animal or insect.

What is going on in the body?

Tularemia is caused by the bacterium Francisella tularensis. Transmission of this infection is usually from the bite of wild or domesticated animals as well as ticks, fleas, and mosquitoes that are infected with this organism. A person may also become infected just by coming in contact with an infected animal (by skinning an infected rabbit, for example).

Risks

What are the causes and risks of the disease?

The bacteria F. tulararensis cause tularemia. A person risks exposure to this bacteria from:
  • close contact with animals and certain insects that are infected with the organism. Hunters and trappers are at risk. In the US, ticks are the main source of infection for humans.
  • contact with other blood-sucking insects
  • direct exposure to an infected animal, such as handling, or skinning infected animals, or eating undercooked meat
  • water contaminated by infected animals

Prevention

What can be done to prevent the disease?

Tularemia can be prevented by wearing gloves and masks when handling potentially infected animals, especially wild rabbits. Game meats should be thoroughly cooked prior to eating. Long pants tucked into socks can protect a person from tick bites. Using insect repellants and removing ticks quickly may also decrease the risk of tularemia.

Diagnosed

How is the disease diagnosed?

Tularemia is usually diagnosed with an antibody titer test that checks the person's blood for antibodies against the bacteria. After the medical history and physical examination, the healthcare professional may order tests, including:
  • biopsy of lymph nodes and sores
  • abdominal ultrasound

Long Term Effects

What are the long-term effects of the disease?

When treated promptly, tularemia seldom has long-term effects. If it is untreated or if treatment is delayed, the infection may affect any part of the body, causing:
  • lung problems, such as pneumonia
  • damage to the cornea of the eye
  • enlargement of the heart
  • infection of the spinal fluid or fluid surrounding the brain, such as meningitis
If untreated, severe forms of tularemia can be fatal.

Other Risks

What are the risks to others?

There have been no documented cases of tularemia being spread from one person to another.

Treatments

What are the treatments for the disease?

Early treatment of tularemia with antibiotics such as streptomycin, gentamicin or fluoroquinolones is vital. For severe cases, hospitalization is necessary to provide intravenous fluids, breathing treatments, and any other needed help. Surgery to drain lesions or lymph nodes may also be necessary.

Side Effects

What are the side effects of the treatments?

Side effects vary with the specific antibiotic. Antibiotics can cause stomach upset, allergic reaction, and rash. Surgery poses a risk of bleeding, infection, and allergic reaction to the anesthesia.

After Treatment

What happens after treatment for the disease?

Outcome after treatment will depend on the extent of illness. A person may recover quickly from tularemia and need no further treatment. If the infection is extensive, surgery and recovery may require more time.

Monitor

How is the disease monitored?

A person who is diagnosed with tularemia should be monitored closely, usually in the hospital.

Sources

Taber's cylcopedic Medical Dictionary, F.A. Davis, 1993

Harrison's Principles of Internal Medicine, Fauci, 1998

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