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Key Information About Tularemia

Tularemia, which is also known as rabbit fever or deer fly fever, is a fatal bacterial disease. It can cause serious illness in both people and pets. It is a zoonosis disease of wide variety of wild birds and mammals.

Francisella Tularensis (Colorized in Blue)

Wikimedia Commons

Wikimedia Commons


Tularemia is caused by gram negative bacteria known as Francisella tularensis. This bacteria can survive in soil, water, and dead animals for weeks.

Most cases occur from being bitten by flies or ticks carrying the bacterium or from exposure to tissue from animal infected with the bacteria.

Francisella tularensis is one of the most infectious pathogenic bacteria known to science--so virulent, in fact, that it is considered a serious potential bioterrorist threat.

F. tularensis is one of six agents classified as a Category A bioterrorism disease, along with anthrax, botulism, plague, smallpox, and viral hemorrhagic fevers.

You can contract this disease by inhaling as few as 10 airborne organisms.

Drinking contaminated water, inhaling contaminated aerosols and laboratory exposure are other ways people can get infected.

"The tick species known to carry the bacteria prefer hares and rodents, but will occasionally bite dogs, cats, or people," said Dr Kimberlee Beckmen, the Alaska Department of Fish and Game veterinarian.

"Even the saliva from the dog's mouth, or even a scratch from a cat who has handled the sick hare can then transmit the bacteria to a person even before the dog or cat get sick," said Dr Beckmen.

Snowshoe hare is the most common carrier of the ticks that spread Francisella tularensis.

In December 2022, a resident of the Boguchansky district, Krasnoyarsk Territory, in central Russia was diagnosed with this bacterial infection. The infection occurred “through contact with raw hare meat,” said Dmitry Goryaev, chief sanitary doctor of the region.

Snowshoe Hare

Wikimedia Commons

Wikimedia Commons



Ulceroglandular tularemia

Skin ulcer, painful lymph glands, swollen lymph glands, chills, fever, headache and fatigue.

Glandular tularemia

Painful lymph glands, swollen lymph glands, chills, fever, headache and fatigue.

Oculoglandular tularemia

Eye pain, red eyes, eye swelling, ulcer on the inside of the eyelid, and sensitivity to light.

Oropharyngeal tularemia

Fever, throat pain, mouth ulcers, vomiting, diarrhea, inflamed tonsils and swollen lymph nodes in the neck.

Typhoidal tularemia

High fever, fatigue, vomiting, diarrhea, enlarged spleen, enlarged liver and pneumonia.

Pneumonic tularemia

Dry cough, chest pain and breathing problems.

A Tularemia Lesion

Wikimedia Commons

Wikimedia Commons

Cady's Case

In April 2014, 13-year-old Cady Stortzum's father noticed something attached to her head.

It was a tick, which he removed. That tick bite eventually led to an ulcer on her head, which was the first sign that something was wrong with Cady.

Her lymph nodes soon swelled up, which in conjunction with severe pain, made it clear that she needed help.

After weeks of misdiagnosis, doctors at Children’s (hospital in Omaha) diagnosed her with tularemia.

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Treatment involves broad-spectrum antibiotics, either administered by a healthcare provider with a needle or taken by mouth.

Streptomycin, gentamicin, doxycycline, and ciprofloxacin are some antibiotics used to treat tularemia.

Treatment usually lasts 10 to 21 days depending on the stage of the disease and the medicines administered.

F tularensis strains generally are resistant to beta-lactam antibiotics, owing in part to beta-lactamase activity.


No vaccine against tularemia is available to the general public.

Appili Therapeutics Inc. announced in March 2022 that the US Department of Defense, via the Joint Science and Technology Office of the Defense Threat Reduction Agency, has selected for funding an Appili proposal that would provide over $10 million to advance the company’s biodefense vaccine candidate ATI-1701, a potential first-in-class vaccine candidate for the prevention of infection with Francisella tularensis, the causative agent of tularemia and a top-priority biothreat.

Emergex Vaccines Holding Limited announced on April 14 2022 that it is progressing preclinical development of its intracellular bacterial vaccine candidate for Francisella tularensis following the completion of successful ligandome generation.

The company plans to combine that technology with its CD8+ T cell Adaptive Vaccine platform.

Emergex intends to use its previously determined repertoire of Class I peptides to generate a CD8+ T cell Adaptive Vaccine as a medical countermeasure for better preparedness against naturally occurring, accidental, or deliberate exposures to the bacterium that causes tularemia.

The risk of infection can be reduced by following these precautions.

Use insect repellents that contain DEET, picaridin or IR3535. Wear long pants, long sleeves and long socks to prevent tick bites.

Avoid contact with untreated water where infection is common in wild animals. Never drink untreated water.

Avoid touching wild animal tissue. Use impervious gloves when skinning or handling animals, especially rabbits. Cook the meat of wild rabbits and rodents thoroughly.

Use a plastic bag when taking a hare away from your pet. Bury dead hare deep enough where pets or other animals can not reach them. Wash hands thoroughly afterward.


For each question, choose the best answer. The answer key is below.

  1. Tularemia is caused by a _______
    • protozoan
    • fungus
    • bacteria
    • virus
  2. Bites from infected ticks and the handling of infected rabbits are responsible for most tularemia cases.
    • True
    • False
  3. Which among these is a symptom of ulceroglandular tularemia?
    • Fever
    • Headache
    • Fatigue
    • All the above
  4. Is gentamicin used to treat tularemia?
    • Yes
    • No
  5. Tularemia can be prevented by drinking untreated water.
    • True
    • False

Answer Key

  1. bacteria
  2. True
  3. All the above
  4. Yes
  5. False

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Srikanth R

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