Tularemia (Rabbit Fever)

  • Medical Author:
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Tularemia and bioterrorism

F. tularensis can be freeze-dried and made into a powder which can be aerosolized. This makes it a potential source of bioterrorism similar to anthrax, botulism, or brucellosis because it could be delivered to large numbers of people. Once inhaled, it is estimated that more than 80% of people would become infected and 6% would die. Inhalation of only about 10-50 bacteria can cause disease. If the number of people exposed was large enough, infected people would overwhelm the health-care system and infected soldiers would be unable to fight. Tularemia is difficult to diagnosis, and few people are immune to the disease.

Is there a vaccine for tularemia?

There is no vaccine for tularemia currently licensed in the United States. An older vaccine made from a weakened strain of F. tularensis had many other problems and was withdrawn. There is great interest in developing a new vaccine, not only to protect those at high risk for disease (lab workers or researchers who routinely handle the bacteria), but also for counterterrorism to reduce the threat of biological warfare. The National Institutes of Health is funding several research projects to develop an effective vaccine against F. tularensis.

If a person is exposed to tularemia in a high-risk situation, such as in a laboratory accident, a two-week course of doxycycline or ciprofloxacin pills is recommended. Exposures from tick bites or other low-risk settings do not require preventive antibiotics.

To reduce the risk of tularemia, hunters should not handle wild animals with their bare hands. If a pet brings a killed rodent inside, the rodent should not be touched by the person who disposes of it. Tick bites can be avoided by wearing long pants and sleeves. Hikers should check themselves for ticks every day. If a tick is found on the body, it should not be removed with bare hands. Insect bites may be minimized by using insect repellents.

Medically Reviewed by a Doctor on 6/10/2015

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