Bureau of Communicable Disease

Tularemia

What is tularemia?

Tularemia is a disease caused by the bacterium, Francisella tularensis that infects both animals and people. Although infection occurs among many wild and domestic animals, the rabbit is most often involved in disease outbreaks. Tularemia is relatively rare in New York City. There have been four cases in NYC since 2000.

Who gets tularemia?

Hunters, hikers, or other people who spend a great deal of time outdoors and who may come in contact with wild animals and their carcasses or who may be bitten by infected ticks are at greater risk for exposure to this organism. Tularemia has been weaponized in state-sponsored bioweapons programs and could, theoretically, be released as a bioterrorism agent.

How is tularemia spread?

The common sources of exposure include inoculation of the skin or mucous membranes with blood or tissue while handling infected animals or meat from infected animals; being bitten by infected ticks or biting flies; and handling or eating insufficiently cooked rabbit meat. Less common means of spread include drinking contaminated water, inhaling dust from contaminated soil, or handling contaminated pelts or paws of animals. It cannot be transmitted from human-to-human.

What are the symptoms of tularemia?

The symptoms of tularemia depend on whether the bacteria enter through the skin, gastrointestinal tract, lungs, or eyes. Tularemia usually is recognized by the presence of a skin ulcer at the location where the bacteria entered the skin and swollen glands. Ingestion of the organism may produce a throat infection, abdominal pain, diarrhea, and vomiting. Inhalation of the organism may produce a pneumonia-like illness. If the organism infects the eyes, it can cause painful swelling of the lids, red eyes, and visual pain.

How is tularemia diagnosed?

Tularemia can be diagnosed by culturing the bacteria from blood, sputum, or wounds; however, it can be difficult to grow. It also can be diagnosed with antibody testing.

How soon after infection do symptoms appear?

Symptoms can appear within 1 to 14 days. Usually, symptom onset occurs within 3 to 5 days of exposure.

What is the treatment for tularemia?

Certain antibiotics, such as streptomycin or gentamicin, are effective in treating tularemia. With appropriate medical treatment, almost all persons recover from tularemia. The infection is rarely fatal.

Does past infection with tularemia make a person immune?

Most persons who have been infected with this organism will become immune to re-infection; however, re-infection has been occasionally reported in laboratory workers.

How can tularemia be prevented?

Rubber gloves, masks, and eye protection should be used when skinning or handling animal carcasses (especially rabbits). Wild rabbit and rodent meat should be cooked thoroughly before eating. Wells and other waters contaminated with dead animal carcasses should not be used. Insect repellants and long clothing should be used when walking through areas known to contain F. tularenis-infected deer flies and ticks. Laboratorians also need to take special precautions when working with bacterial specimens that could contain F. tularensis.

Last updated June 2008