Tularemia

What is Tularemia?

Tularemia, also known as “rabbit fever,” is a potentially serious illness that occurs naturally in the United States.  It is caused by the bacterium, Francisella tularensis, found in animals, especially rodents, rabbits, and hares.  

How do people become infected with tularemia?

People can get tularemia several ways:

  • By being bitten by an infected tick, deerfly, or other insect
  • By handling infected animal carcasses
  • By eating or drinking contaminated food or water
  • By breathing in the bacteria, F. tularensis

Tularemia is not known to spread from person to person.  People who have tularemia do not need to be isolated.

How common is tularemia?

Tularemia is a widespread disease in animals. About 200 human cases of tularemia are reported each year in the United States. Tularemia is usually a rural disease and has been reported in all U.S. states except Hawaii, although most cases occur in the south-central and western states.  Nearly all cases occur in rural areas, and are caused by the bites of ticks and biting flies or from handling infected rodents, rabbits, or hares. Cases have also resulted from inhaling airborne bacteria and from laboratory accidents. 

How soon do infected people get sick?

Symptoms usually appear three to five days after exposure to the bacteria, but can take as long as 14 days.

What are the symptoms of tularemia?

People who have been exposed to the tularemia bacteria should be treated as soon as possible. Tularemia can be fatal if the person is not treated with the right antibiotics. Symptoms of tularemia could include:

  • Sudden fever
  • Chills
  • Headaches
  • Diarrhea
  • Muscle aches
  • Joint pain
  • Dry cough
  • Progressive weakness

What should I do if I think I have tularemia?

If you suspect you were exposed to tularemia bacteria, see a doctor quickly. Treatment with antibiotics for a period of 10-14 days or more after exposure may be recommended. If you are given antibiotics, it is important to take them according to the instructions you receive. You must take all of the medication you are given.

Can tularemia be effectively treated with antibiotics?

Yes. Early antibiotic treatment is recommended whenever it is likely a person was exposed to tularemia or has been diagnosed as being infected with tularemia. Several types of antibiotics have been effective in treating tularemia infections.  Antibiotics can either be taken by mouth or by injection into a muscle.  Health officials will test the bacteria in the early stages of the outbreak to determine which antibiotics will be most effective.

Is there a vaccine available for tularemia?

A vaccine for tularemia is under review by the Food and Drug Administration and was not available in the United States when this fact sheet was published. 

What can I do to prevent becoming infected with tularemia?

Tularemia occurs naturally in many parts of the United States.  Use insect repellant containing DEET on your skin, or treat clothing with repellent containing permethrin, to prevent insect bites.  Wash your hands often, using soap and warm water, especially after handling animal carcasses.  Be sure to cook your food thoroughly and get your water from a safe source.  

Note any change in the behavior of your pets (especially rodents, rabbits, and hares) or livestock, and consult a veterinarian if they develop unusual symptoms.

Can tularemia be used as a weapon?

Francisella tularensis is very infectious. A small number of bacteria (10-50 organisms) can cause disease. If Francisella tularensis were used as a biological weapon, the bacteria would likely be made airborne so they could be inhaled.  People who inhale the bacteria can experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated.  The bacteria that cause tularemia occur widely in nature and could be isolated and grown in quantity in a laboratory, although manufacturing an effective aerosol weapon would require considerable sophistication.

What is Michigan doing to combat this health threat?

The Michigan Department of Health and Human Services works closely with physicians and laboratories to make them aware of the signs and symptoms of tularemia and to be able to identify tularemia.  Increased surveillance by local health departments is incredibly important in our efforts to detect bioterrorism, investigate potential cases, and ensure that patients will be cared for properly with minimal risks.  Hospitals, health care providers, and health departments throughout the state are prepared to follow the protocols and recommendations for care set by the Centers for Disease Control and Prevention to ensure patient safety.

For more information on tularemia:

Visit The Centers for Disease Control and Prevention (CDC) Tularemia webpage at http://www.cdc.gov/tularemia.