What Is Tularemia?

Causes

People can become sick with tularemia, but it’s not a disease that naturally occurs in humans. It often affects rabbits and other animals including rodents, sheep, and birds. House pets like dogs and cats can get tularemia too.

These are some of the ways people can get it:

Insect bites, especially from a deer fly or tick
Coming into contact with the skin, hair, or meat of an animal that’s infected
Consuming contaminated water or food, such as undercooked meat
Breathing in bacteria that comes up from the soil during an activity like construction or gardening

It’s also possible to become infected if you’re exposed to the bacteria in a laboratory setting, or potentially, in an act of bioterrorism.

Tularemia can happen anywhere in the world, but it’s most common in rural areas where animals are more likely to be infected with the bacteria. It can survive in soil, water, and dead animals for weeks. That’s why it can cause infections in so many different ways.

The way you become infected with the disease influences the type of symptoms you’ll have and how severe they may be. But just because you’re exposed to the bacteria doesn’t mean you’ll become sick with the disease.

Symptoms

If you do become sick after being exposed to Francisella tularensis, you’re likely to start having symptoms within 3 to 5 days, but it can take up to 2 weeks. There are different types of tularemia that each have their own specific symptoms.

Ulceroglandular tularemia is the most common variety of the disease. Symptoms can include:

An ulcer on the skin that’s usually caused by a bite from an infected animal or insect
Lymph glands that are painful and swollen
Fever
Chills
Headache
Fatigue

Oculoglandular tularemia affects the eyes. Symptoms can include:

Pain, swelling, or discharge in the eye
Redness in the eye
Light sensitivity
An ulcer that forms inside the eyelid
Tender lymph glands around the ear, neck, and jaw

Oropharyngeal tularemia affects the mouth, throat, and digestive system. It’s the form of the disease that’s most often caused by eating undercooked meat from a wild animal or drinking water that’s contaminated. Symptoms can include:

Throat pain
Vomiting
Diarrhea
Swollen tonsils or lymph nodes in the neck
Ulcers in the mouth
Fever

Pneumonic tularemia can cause symptoms that are often associated with pneumonia, including:

Trouble breathing
Pain in the chest
A dry cough

Typhoidal tularemia is a rare, but very serious form of the disease. Symptoms can include:

An enlarged spleen or liver
Diarrhea and vomiting
Severe fatigue
Elevated fever

Who’s at Risk?

Tularemia is rare. There were only 229 reported cases in the United States in 2018. People get it most from tick bites or contact with a contaminated animal.

The following can also increase your risk for developing tularemia:

Jobs such as laboratory worker, farmer, veterinarian, hunter, landscaper, wildlife manager, and meat handler
Living in or visiting the south-central United States
Hunting or gardening. Wild animals may be infected with tularemia, and stirring up soil may cause bacteria to be released.

Diagnosis and Treatment

It can be hard to diagnose tularemia because the symptoms can be similar to other diseases. Your doctor will test you to confirm the bacteria is present. They may also order a chest X-ray to check for signs of pneumonia.

Treatment usually involves antibiotics, either injected or by mouth. If you have complications like pneumonia or meningitis, you’ll also need treatment for these conditions. Usually people who have had tularemia become immune to it, but some people get it more than once.