Tularemia is a rare infectious disease. It usually affects the skin, eyes, lymph nodes as well as the lungs and is also known as rabbit fever or deer fly fever. The Francisella tularensis bacterium causes Tularemia.

Rabbits, hares, and rodents (like muskrats and squirrels) are mainly affected by the disease. Bees, sheep, and household animals such as dogs, cats, and hamsters may also be affected by Tularemia.

Tularemia spreads to humans in many ways through insect bites and direct exposure to an infected animal. Tularemia is extremely infectious and potentially lethal, but it can typically be treated with specific antibiotics effectively if detected early.


Most individuals who become ill with Tularemia normally do so within three to five days, but it can take as long as 21 days. There are several forms of Tularemia, and how and where the bacteria reach the body depends on which type you have.

Every kind of Tularemia has a collection of symptoms of its own, and they include:

Ulceroglandular tularemia

This is the most prevalent type of the disease, and symptoms, as well as signs, include:

  • A skin ulcer that occurs, typically from an insect or animal bite, at the area of infection
  • Distressing and swollen lymph glands
  • Fever
  • Chills
  • Headaches
  • Fatigue

Glandula Tularemia

People who have glandular Tularemia have similar symptoms of ulceroglndular Tularemia but without skin ulcers.

Oculoglandular Tularemia

The eyes are affected by this form and can cause:

  • Eye pain
  • Eye redness
  • Eye Swelling and discharge
  • Ulcer inside of the eyelid
  • Light-sensitivity

Oropharyngeal Tularemia

The mouth, throat, and digestive tract are affected by this form of Tularemia. Symptoms and signs include:

  • Fever
  • Throat Pain
  • Mouth Ulcers
  • Abdomen Pain
  • Vomiting
  • Diarrhea
  • Inflamed Tonsils
  • Bulged lymph nodes in the neck

Pneumonic Tularemia

This form of Tularemia triggers pneumonia-related symptoms, and they include:

  • Dry cough
  • Chest pain
  • Difficulty Breathing

Other kinds of Tularemia can also migrate to the lungs.

Typhoidal Tularemia

Typically, this unusual and dangerous form of the disease causes:

  • High fever and chills
  • Muscles pain
  • Sore throat
  • Diarrhea and vomiting
  • Widened spleen
  • Enlarged liver
  • Pneumonia

Causes of Tularemia

Tularemia does not occur spontaneously in humans and is not known to transfer from individual to individual. However, Tularemia occurs globally, especially in rural areas, as many mammals, birds, and insects are infected with F. tularensis. Tularensis can survive for weeks in the soil, water, and dead animals.

Tularemia has many transmission modes, unlike other infectious diseases that transmit from animals to individuals in only one way. The kind and severity of symptoms are generally determined by how you get the disease.

Tularemia can usually be acquired through:

  • Insects bite: While various insects transmit Tularemia, ticks and deer flies are most likely to transmit the illness to humans. A significant percentage of cases of ulceroglandular Tularemia arise from tick bites.
  • Exposure to dead or sick animals: Ulceroglandular Tularemia may also arise from an infected animal (rabbit or hare) by touching or being bitten. Bacteria can enter the skin via tiny cuts and bruises or a bite, and at the wound area form an ulcer. The ocular type of Tularemia can happen when you touch your eyes after handling an infected animal.
  • Airborne bacteria: Bacteria in the soil may become airborne during planting, building, or other actions that disrupt the earth. Pneumonic Tularemia can result from inhaling the bacteria. Airborne contamination is also at risk for laboratory staff working with Tularemia.
  • Contaminated water or food: While rare, Tularemia can be acquired by consuming an infected animal’s undercooked meat or drinking polluted water.

Risk factors

While anyone of any age may develop Tularemia, there is a higher chance of contracting the disease when participating in certain professions or activities or living in certain areas.

Residing in or visiting certain areas

Tularemia has been recorded in the United States, Canada, Mexico, Japan, and Europe. It is typically more prevalent in Arkansas, Missouri, Oklahoma, and South Dakota in the United States, but there were outbreaks in 2015 in Colorado, Nebraska, and Wyoming.

Parts of Massachusetts, such as the Martha’s Vineyard and Nantucket, have also recorded Tularemia.

Engaging in certain professions or activities

You may increase the likelihood of having Tularemia with the following:

  • Trapping and hunting: Hunters are in danger of Tularemia since they are exposed to wild animal blood and can consume wild animal flesh.
  • Landscaping or gardening: Tularemia can also pose a danger to gardeners and landscapers. Gardeners can inhale bacteria that are provoked during soil activity or when lawnmowers and weed trimmers are used.
  • When employed in the care of wildlife or veterinary medicine: There is an increased risk of Tularemia among people who work with wildlife or domestic animals.


Tularemia, when left unchecked, can be dangerous. Possible further complications include:

  • Pulmonary inflammation (pneumonia): Pneumonia may lead to respiratory failure, a condition in which the lungs don’t absorb enough oxygen, and when not enough carbon dioxide is released.
  • Infection around the spinal cord and brain (meningitis): Meningitis is a severe and often life-threatening infection of the brain and spinal cord surrounding the fluid and membranes (meninges).
  • Irritation around the heart (pericarditis): This is inflammation of the thin membrane covering the heart (pericardium).
  • Bone infection (osteomyelitis): Tularemia is often dispersed to the bones by bacteria.


There is no active immunization for Tularemia presently. These steps can help decrease the chance of infection if you work in a high-risk profession or reside in a place where Tularemia is present:

  • Secure yourself from insects: Tularemia is sometimes associated with a tick bite in the United States. It is generally transmitted through mosquito bites in other parts of the globe. Wear long-sleeved shirts and long trousers, tuck your pants into your socks and use a wide-brimmed hat to help cover your face and neck if you spend time in tick or mosquito-infested areas.
  • Use an insect repellent with DEET, picaridin, or IR3535 at 20 to 30 percent, but closely follow the manufacturer’s instructions. In moderation, add insect repellent and wash it off at the end of the day. Check yourself regularly for ticks and, if you notice any, remove them instantly. Be sure to get your pets tested, too.
  • Carefully treat your poultry: Wear gloves and protective goggles. Clean your hands properly with soap and hot water after handling the animal if you hunt or treat wild rabbits or hares.
  • Don’t eat undercooked meat: Thoroughly cook all wild meat, and avoid skinning or dressing any animal that appears ill. Heat kills F. Tularensis, so cook meat at the correct temperature to make it safe to consume, at least 160 F (71.1 C) for ground meat and game meat. Poultry should be cooked up to 165 F (73.8 C).
  • Protect your dogs: Livestock and pets may contract Tularemia when they ingest part of a diseased rabbit or are bitten by an infected tick. Avoid leaving them unattended outdoors to help keep your pets safe, and provide them with the protection they need against fleas and ticks. Do not let them come into close contact with wild or dead animals.

When you should visit  a doctor

See a doctor immediately if you feel you might have been subjected to Tularemia. This is particularly true if you have been bitten by a tick or have handled a wild animal in a region where Tularemia is detected.

Also, visit the doctor when you notice the following: fever, skin ulcers, or swollen glands.