Tularemia

Tularemia is an infectious disease which is found rarely. It typically affects skin, eyes, lymph nodes and lungs. It is caused by the bacteria called Francisella tularensis. 

It is mostly found among mammals, especially rodents and spreads to humans either by direct contact or through insect bites. This potentially fatal disease  is treatable, if discovered early.

Signs and symptoms of tularemia vary depending on its type.

Incubation period for this disease can take anywhere from 3 to 14 days.  Depending on how and where the bacteria entered the body, there are several types of tularemia:

Ulceroglandular tularemia – this form of tularemia is most commonly found. Signs and symptoms include a skin ulcer at the infection site,  fever, chills, swollen lymph glands, exhaustion and headache.

Glandular tularemia – symptoms similar to ulceroglandular form but without  ulcers.

Oculoglandular tularemia – eyes are most affected. Signs ans symptoms include eye redness, pain, eye discharge,conjuctival ulcers and sensitivity to light.

Oropharyngeal tularemia – this form affects the mouth, throat, and GIT. The cause for this form is, in most cases, eating contaminated wild animal meat and drinking contaminated water. It is followed with diarrhea, vomiting, fever, mouth ulcers, tonsilar inflammation and lymph-node swelling. 

Pneumonic tularemia – affects lungs. Symptoms include chest pain, dry cough, difficulty breathing.

Typhoidal tularemia – this form is generally rare. Symptoms include high fever, hepatomegaly, splenomegaly, extreme exhaustion.

If you get bitten or come into contact with a wild animal, which you suspect carries this bacteria, or experience the above-mentioned symptoms, please see your doctor as soon as possible. 

Tularemia is caused by the bacteria called Francisella tularensis.

Tularemia is an infectious disease which spreads from animals to people. Interhuman transfer has not yet been described. Because of the presence of F.tularensis  in various animals, tularemia occurs worldwide, especially in rural areas. 

This bacteria can live in soils, water or dead animals too. As a result of having various ways of transmission, the symptoms of this disease tend to match the way of entrance.You can get infected with F.tularensis through: 

• Insect bites – mostly ticks and deer flies
• Exposure to sick or dead animals – either from handling or being bitten by them. Bacteria can enter the skin through cuts and abrasions, and your eyes by rubbing them after touching the animal. This way of transmission is characterized by the presence of ulcer at the entrance site.
• Airborne bacteria – there is a possibility of inhaling the bacteria from the soil during construction work, gardening, in laboratories etc. This can lead to pneumonic tularemia.
• Undercooked meat and contaminated water – causes digestive and oropharyngeal symptoms.

Making a diagnosis of tularemia is done by performing several tests.

If you experience any symptoms of tularemia after coming into contact with animals or their products, you should see your primary care doctor. He might refer you to the infectious diseases specialist. Do not forget to mention all the symptoms you are experiencing and chronology of their development. Also include all of your recent activities, contact with animals and visits to tick-infested areas.

Doctors may look for F.tularensis in your blood or sputum or specific blood-antibodies.

Other diagnostic methods include chest X ray, in order to check your lungs.

Treatment of Tularemia is consisted of antibiotics such as streptomycin or gentamicin. Antibiotics are given either intravenously or intramuscularly. In some cases, depending on the the type of tularemia, oral antibiotics such as doxycycline can be prescribed. 

Generally speaking you should become immune to reinfection after recovering from the disease, but in rare cases reinfections have been described.

If you have a high-risk occupation or spend time in areas where tularemia is present, you should consider taking these preventive measures:

• Protect yourself from insects, especially tick bites – wear shirts with long sleeves, long pants, boots, hat and tuck your pants in your socks. Check your skin and clothes for tick regularly.
• Use an adequate insect repellent.
• Handle animals carefully – wash your hands with soap after touching the animals and wear gloves and protective goggles. 
• Cook all wild meat carefully and make sure that the cooking temperature is high enough.
• Make sure to protect your pets as well.

Vaccine for the disease is still publicly unavailable.

There are several risks and complications associated with tularemia.

Having certain occupations or working and living in certain areas can pose a greater risk for this infection. These occupations include:

• hunting, gardening,
• working in veterinary medicine,
• working in construction etc. 

Complications include:

• lung infection,
• respiratory failure,
• brain infection ( encephalitis),
• brain and spinal cord protective membranes infection (meningitis),
• heart membrane infection (pericarditis).

If not treated, tularemia can be fatal.