Tularemia, often referred to as “rabbit fever,” has seen a significant increase in reported cases across the United States over the past decade, according to a recent report from the Centers for Disease Control and Prevention (CDC). This disease, caused by the bacterium Francisella tularensis, is a rare but potentially serious infection that is spread through a variety of means, including the bites of infected ticks and deer flies, direct contact with infected animals, and even unexpected exposure such as contact with contaminated animals. Involves mowing down grass on a bird’s nest.

What is tularemia?

Tularemia mainly affects animals such as rabbits, hares and rodents, which are particularly susceptible to the disease. Humans can contract infection through several routes:

– Insect bites: Infected ticks and deer flies are common vectors.

– direct contact: Skin contact with infected animals or handling contaminated animal tissues.

– Aerosolized bacteria: Activities such as mowing grass over infected nests can release bacteria into the air, posing a risk of inhalation exposure.

This last mode of transmission has been documented in events such as the 2000 outbreak at a Massachusetts vineyard, where lawn mowing led to 15 cases and one death over six months. Similar cases were reported in Colorado in 2014 and 2015, further underscoring the dangers of unintentional exposure.

Increasing numbers and better testing

From 2011 to 2022, 2,462 cases of tularemia were reported in 47 states, representing a 56% increase from the previous decade. Although this equates to only one case per 200,000 people, the increase is notable given the rarity of the disease.

Improvements in diagnostic methods have probably contributed to the increase in reported cases. In 2017, the CDC expanded its criteria for “probable cases” to include cases where F. tularensis was detected. This change, along with advances in laboratory testing, has improved identification accuracy.

Of the total cases reported from 2011 to 2022, 984 were classified as “confirmed” based on bacterial isolation or significant antibody changes, while 1,475 were considered “probable”. Probable cases account for 60 percent of total cases, a significant increase from the 35 percent seen in the last decade.

Who is most at risk?

Certain demographics face a higher risk of getting tularemia:

– American Indian or Alaska Native population: Incidence rates in these communities were five times higher than in the white population, possibly due to factors such as geographic location, occupational exposure, and socio-cultural practices.

– Children aged 5-9: This group is more vulnerable due to increased contact with infected wildlife due to outdoor activities.

– Older adults: Higher rates of infection were also seen in men aged 65-84.

– Central American residents: The disease is more prevalent in states where contact with wildlife is common.

Challenges in diagnosis and treatment

tularemia symptoms Varies widely depending on mode of transmission, making diagnosis challenging. Common symptoms include fever, chills, fatigue, and local pain, but the disease can manifest differently in different cases.

Despite its rarity, tularemia can be serious and even fatal without prompt treatment. The CDC notes that while the typical case fatality rate is less than 2 percent, certain strains and clinical presentations may increase the risk.

preventive measures

Understanding how tularemia is spread is key to preventing exposure. Here are some tips to reduce the risk:

-Avoid insect bites: Use insect repellent, wear protective clothing and check for ticks after spending time outside.

– Handle wildlife with care: Avoid contact with sick or dead animals and use gloves when handling animal carcasses.

– Be careful when mowing the grass: Avoid mowing in areas where wildlife nests may be present.

– Practice hygiene: Wash hands thoroughly after outdoor activities or handling animals.

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