Introduction
Tularemia, also known as rabbit fever, is a rare but potentially serious infectious disease caused by the bacterium Francisella tularensis. It primarily affects wild animals, especially rabbits, hares, and rodents, but humans can become infected through various routes. Tularemia is found in North America, Europe, and parts of Asia. Early recognition and prompt treatment are important to prevent complications.
Causes
Tularemia is caused by the bacterium Francisella tularensis. Humans can become infected through:
- Insect Bites: Especially from ticks and deer flies that have fed on infected animals.
- Direct Contact: Handling infected animals, particularly rabbits and rodents.
- Inhalation: Breathing in dust or aerosols contaminated with the bacteria, which can occur during activities like mowing or landscaping in endemic areas.
- Ingestion: Drinking contaminated water or eating undercooked meat from infected animals.
Tularemia is not spread from person to person.
Symptoms
Symptoms usually appear 3 to 5 days after exposure but can range from 1 to 14 days. The form and severity of symptoms depend on the route of infection:
- Ulceroglandular Tularemia (most common):
- Skin ulcer at the site of infection (often from an insect bite or animal contact)
- Swollen and painful lymph nodes near the ulcer
- Glandular Tularemia:
- Swollen lymph nodes without an ulcer
- Oculoglandular Tularemia:
- Eye pain, redness, swelling, and discharge
- Swollen lymph nodes near the ear or jaw
- Oropharyngeal Tularemia:
- Sore throat, mouth ulcers, tonsillitis
- Swollen lymph nodes in the neck
- Pneumonic Tularemia:
- Cough, chest pain, difficulty breathing
- Can develop after inhaling bacteria or as a complication of other forms
- Typhoidal Tularemia:
- High fever, fatigue, weight loss, and systemic illness without localized symptoms
General symptoms may include sudden fever, chills, headache, muscle aches, joint pain, and fatigue.
When to Seek Medical Attention
Seek medical care if you develop a sudden fever, skin ulcer, swollen lymph nodes, or respiratory symptoms after possible exposure to wild animals, insect bites, or contaminated environments, especially in areas where tularemia is known to occur.
Diagnosis
Diagnosis is based on:
- Medical History: Recent exposure to wild animals, insect bites, or activities in endemic areas.
- Physical Examination: Assessment of ulcers, lymph nodes, and other symptoms.
- Laboratory Tests: Blood tests, cultures, or PCR to detect Francisella tularensis.
Treatment Options
Prompt antibiotic treatment is essential and usually involves:
- Antibiotics: Such as streptomycin, gentamicin, doxycycline, or ciprofloxacin.
- Supportive Care: Includes fluids, pain relief, and management of complications.
- Hospitalization: May be required for severe cases or complications.
Prevention
Preventive strategies focus on reducing exposure:
- Avoid Handling Wild Animals: Especially rabbits and rodents in endemic areas.
- Use Insect Repellent: To prevent tick and deer fly bites.
- Wear Protective Clothing: When working outdoors in areas where tularemia is present.
- Cook Meat Thoroughly: Avoid eating undercooked wild game.
- Protect Against Aerosols: Use masks or take precautions when mowing or landscaping in endemic areas.
Takeaway
Tularemia is a rare but potentially serious disease that can be treated effectively with antibiotics if diagnosed early. Preventive measures and awareness of risk factors are key to reducing the risk of infection, especially for people who spend time outdoors or handle wild animals.