Tularemia

Tularemia General Information

Tularemia is a rare infectious disease that damages the eye, skin and lungs and is caused by a gram negative bacterium called francisella tularensis. Less than 150 cases are reported each year in the United States, especially in the states from west and central south. Other areas where the disease occurs more often are Africa and parts of Europe. This type of medical condition has multiple various names, including: rabbit fever, Ohara disease, Lemming fever, Pahvant valley plague, deer-fly fever, Yatobyo (in Japanese) or Francis disease.

This non-motile coccobacillus is contracted from wildlife, usually from mammals, such as rabbits, rodents and hares; the infection can also attack fish, birds or reptiles. Humans get very easily infected, through several routes, for example touching or eating sick animals (direct exposure to infected animals), insect bites etc. This is why more prone to develop this type of medical condition are laboratory workers, hunters, fur handlers, farmers and butchers. During the cold season, the infections in humans result from contact with wild rabbits, while in the summer, the infection is a result of insect bites (deer flies, horse flies, mosquitoes or ticks). Tularemia, although rare, represents a possible important bio-weapon because it is very contagious and fatal if doctors do not treat it in time. An early diagnosis increases the chances for a full recovery if it is followed by a treatment based on antibiotics. Tularemia can not be transmitted from person to person, but can be caused if people consume contaminated water or undercooked and raw infected meat.

Tularemia Symptoms

When dealing with Tularemia, people become sick within three to nine days after the infection with the bacterium. The main signs and symptoms of this medical condition are very common and may indicate other similar conditions. Because our immune system reacts in a different way when it is attacked by harmful agents, some persons may accuse particular and unique symptoms. Specialists have classified the symptoms of Tularemia according to the six types of the disease that exist. The most common form of this infectious disorder is the ulcero-glandular type, characterized by high fever, exhaustion, and headache, a skin ulcer (red spots on the skin) that appears at the infections sites (animal or insect bites), chills and swollen and painful lymph nodes of the armpits and groin.

The glandular type presents the same signs and symptoms as the ulcero-glandular type, except no skin ulcers. Swelling of the eyes, possibly conjunctivitis, discharge, ulcers on the inside of the eyelid and eye redness and pain are specific for the oculo-glandular type. When Tularemia affects the digestive tract, patients will experience severe diarrhea, accompanied by nausea and vomiting, weakness and dehydration. If the infection reaches the lungs, the typical signs are: pain felt in the chest area, persistent cough, difficulty breathing etc. Pneumonia can sometimes develop, but causes mild signs and symptoms, although some people can become delirious. A rarer form of this infectious medical condition is the typhoidal type that includes weight loss, high fever (more than 40oC), profuse drenching sweats and extreme tiredness.

Tularemia Treatment

Like in the case of other medical conditions, an early diagnosis of Tularemia and a proper treatment applied in time are extremely important due to the fact that the chances for a full recovery increase significantly. If you develop signs and symptoms specific for Tularemia after you have been bitten by a tick, rodent or have been exposed to the flesh of an infected wild animal, we strongly advise you to contact your health care provider or any other specialist in this type of medical disorders. During the medical examination you will speak about your signs and symptoms, personal medical history; after, the health care provider may want to do a physical exam. Your doctor may also ask you to do some of these tests that might help him set the exact diagnosis and rule out other possible similar conditions: X-ray of the chest, serology culture, blood culture and polymerase chain reaction (PCR) test (of a small sample from a skin ulcer).

This infectious disease-Tularemia-is usually treated with antibiotics, for example Gentamicin and Streptomycin, administrated into the veins (IV, intravenously) or into the muscles. The main treatment option consists in injection with Streptomycin for one to two weeks or with Gentamicin for at least ten days. Depending on the type of the disease, health care providers may choose to prescribe Tetracycline-class drugs (for example Doxycycline administrated for more than fifteen days, Fluoroquinolones and Chloramphenicol) or other oral antibiotics. Tetracycline must not be prescribed for children if their permanent teeth have not erupted because it discolors the teeth that are still forming. If any complications appear, for example pneumonia or meningitis, they must be immediately treated; if not, they interfere in the process of curing this infectious disease called Tularemia and can affect seriously the patient’s quality of life. You must avoid losing a dose or overdosing because you may develop allergies that are harder to treat. Follow the indications of the health care provider and the prescriptions from the drug package.

Recurrence is very rare in the case of Tularemia; many patients develop immunity to this disease after they recover. Relapses occur if an inadequate treatment was applied. The intense headaches are usually managed with Codeine or other Opioid pain relievers. If a person presents sores, moist bandages (that prevent the spread of the infection) must be placed on them and changed permanently. Wearing dark sun glasses and applying worm compresses may offer some eye relief. With the proper treatment applied in time, the prognosis is good and the expectations high. Only in 3% of the untreated cases and in less than 1% of treated patients this infectious disease becomes fatal. Death usually occurs from peritonitis (infection of the lining of the abdominal cavity), pneumonia, overwhelming infections or Meningitis (infection of the tissues that cover the spinal cord and brain). This disease can be very easily prevented by doing an attenuated, live vaccine for people who present a high risk of developing it, for example laboratory workers, hunters, butchers, trappers etc).