Tularemia is an infectious disease that typically infects:
- wild rodents
Humans can become infected by having direct contact with an
infected animal or from tick, mosquito, or deer fly bites. The disease is
caused by the bacterium Francisella tularensis. It can be
The various forms of tularemia are distinguished by where the
bacteria enter the body. The most common form of the disease is caused by skin
contact with the bacteria. The deadliest form of the disease is caused by inhaling
Tularemia can often be treated with antibiotics. Early treatment
offers a good outlook for complete recovery. However, some severe cases may be
fatal even with treatment.
Tularemia is rare. There are usually 100 to 200 reported
cases in the United States each year.
The symptoms vary depending on where the bacteria enters your
The symptoms of ulceroglandular
tularemia, or infection through the skin, can include:
- a skin ulcer at the point of contact with the
infected animal or at the site of a bite
- swollen lymph nodes near the skin ulcer (most
often in the armpit or groin)
- severe headaches
- a fever
The symptoms of glandular
tularemia, or infection through the skin, are similar to ulceroglandular
symptoms but without a skin ulcer.
is the deadliest form of this disease. It’s transmitted through inhalation. The
symptoms can include:
- a dry cough
- breathing difficulty
- a high fever
- chest pain
The symptoms of oculoglandular
tularemia, or infection of the eye, can include:
- eye irritation
- eye pain
- eye swelling
- discharge or redness of the eye
- a sore on the inside of the eyelid
- swollen lymph glands behind the ear
The symptoms of oropharyngeal
tularemia, or infection through ingestion of the bacteria, can include:
- a sore throat
- ulcers in the mouth
- swollen lymph nodes in the neck
- tonsillitis, or swollen tonsils
The symptoms of the rarest form of this disease, typhoidal tularemia, can include:
- a very high fever
- extreme fatigue
Typhoidal tularemia can lead to pneumonia and an enlarged liver
Severe and untreated cases of tularemia may cause:
- chronic heart failure
- swelling of the membranes that surround your
brain and spinal cord, which is called meningitis
The bacterium F. tularensis causes tularemia. Creatures
capable of carrying the bacteria include:
- rabbit and deer ticks
- grizzly bears
- cats that go outdoors
Which type of tularemia you develop depends on how the bacteria
enters your body. Skin exposure is the most common form of the disease.
Inhalation through the lungs is the deadliest form of tularemia. If it’s left
untreated, other forms of the disease may eventually reach the:
- spinal cord
The disease can cause serious complications and sometimes death.
The route of entry and resulting forms of tularemia include the
- Skin exposure causes glandular or
- Inhalation of aerosolized bacteria causes
- Exposure through the eye causes oculoglandular
- Ingestion causes oropharyngeal tularemia.
- Systemic infection causes typhoidal tularemia.
Factors for Tularemia
Animals carry the bacteria that causes tularemia. You’re at increased
risk of getting the disease if you have frequent contact with animals.
People at an increased risk for tularemia include:
- those who work closely with animals, such as veterinarians,
zookeepers, and park rangers
- those who live in heavily forested areas
- those who work with animal carcasses, such as
hunters, taxidermists, and butchers
- those who work in gardening and landscaping
Diagnosing tularemia isn’t easy because it can often appear like
other diseases. The various possible routes of entry of the bacterium
complicates the issue. Your doctor must rely heavily on a your personal and
medical history to help diagnose you.
Your doctor may suspect tularemia if you’ve had recent travels,
insect bites, or contact with animals. They may also suspect that you have this
disease if you already have a serious medical condition that compromises your
immune system, such as cancer or HIV or AIDS.
Tests for the presence of this disease include:
- a serology test for antibodies your body has
created to fight the bacteria
- a pleural fluid test, which tests the fluid from
the pleurae in the chest cavity
- a skin biopsy of a lesion and microscopic exam looking
for the presence of tularemia
- a lymph node biopsy, which is the removal of
tissue from a lymph node for examination
- a bone marrow biopsy, which is the removal of a
sample of bone marrow for examination
Each case of tularemia is treated according to its form and
severity. Early diagnosis allows for immediate treatment with antibiotics.
Antibiotics that may be used to treat tularemia include:
Surgical intervention may be required to drain swollen lymph
nodes or to cut away infected tissue from a skin ulcer. You may also be given
medications for fever or headache symptoms.
Your outlook depends on the severity of the condition and how
quickly you start receiving treatment. Delays in diagnosis will cause a
worsening of symptoms.
Hospitalization is common in many cases. The most severe type of the
disease is pneumatic tularemia. About 2 percent of
tularemia cases are fatal. Most of these are pneumatic tularemia cases.
Prevention involves taking basic safety precautions. The bacteria
thrive in dirty conditions. Outbreaks of this disease have occurred in hunting
parties when hunters failed to practice safe cleaning methods and contaminated
To safely clean animals when hunting, you should take the
- Don’t skin or dress (remove the organs of) any
animal that appears to be sick.
- Wear gloves and goggles when handling any animal.
- Wash your hands carefully after handling an
- Cook the meat thoroughly.
To decrease your overall risk of contracting tularemia, you
- Wear long pants and sleeves in the forest to
help prevent tick bites.
- Keep animal remains away from food or water.
- Avoid drinking water from lakes or ponds.
- Protect your outdoor pets with flea and tick
- Use insect repellents.
Tularemia is easily aerosolized and can be a potentially deadly
bioterrorism agent, although you’re much more likely to become infected from
contact with an animal. You should talk to your doctor immediately if you think
you might have tularemia.