What is tularemia?
Tularemia is an infectious disease caused by the bacteria Francisella tularensis. These bacteria are widely distributed in the environment and can infect a wide variety of animal species, including humans, domestic animals, and wildlife. Rabbits, hares, squirrels and other rodents are especially susceptible.
Cases of tularemia in Washington are rare, with 1-10 cases in humans and 0-2 cases in animals reported each year.
How is tularemia spread?
People can become infected after handling infected animals or animal tissues, through bites from infected animals, tick or deer fly bites, consumption of contaminated food or water, or inhalation. In Washington, inhalation of contaminated dust while using farm or landscaping equipment (particularly riding lawn mowers) is the most common type of exposure reported. This can occur when machinery runs over infected animals or carcasses. Bites from infected squirrels are another common source of infection in our state. Occupational exposures may occur, particularly in outdoor, veterinary, wildlife biology, or laboratory settings. Tularemia is not spread from person-to-person.
Who is at risk?
People who handle animals for their jobs or while hunting and people who work with landscaping equipment or heavy machinery outdoors are most at risk of tularemia. People who work or recreate in areas where tick or deer fly bites may occur are also at risk.
What are the symptoms of tularemia?
Symptoms of tularemia vary depending on how the bacteria enter the body. Almost all cases report fever, chills, headache, or body aches, along with one of the following forms of illness:
- Ulceroglandular: a non-healing skin ulcer at the site of a bite or broken skin contact with an infected animal, accompanied by large, tender regional lymph nodes.
- Glandular: large, tender regional lymph nodes without skin lesions.
- Oculoglandular: conjunctivitis (painful red eyes) and tender lymph nodes in front of the ear or in the neck.
- Pharyngeal: sore throat and tender lymph nodes in the neck.
- Pneumonic: cough, difficulty breathing, chest pain, pneumonia
Other rare forms of tularemia are also possible, including endocarditis, meningitis, and septic arthritis. The severity of illness depends on the route of infection, dose, and infecting strain.
How can I protect myself and others from tularemia?
When mowing, landscaping, or working with heavy equipment outdoors:
- Don’t mow or run over sick or dead animals with machinery. When possible, check the area for carcasses prior to mowing or using machinery.
- Using a mask during mowing or use of machinery may reduce your risk of inhaling bacteria or other pathogens from the environment.
When hunting, trapping, or skinning animals:
- Do not handle sick or dead animals.
- Use gloves when handling animals, especially rabbits, muskrats, prairie dogs, squirrels, or other rodents.
- Wash hands thoroughly with soap and water when finished dressing game and after removing gloves.
- Cook game meat thoroughly before eating.
When working or recreating outdoors:
- Treat clothing and gear with permethrin and wear an EPA-registered insect repellant.
- Wear long pants and long sleeves to keep ticks and deer flies away from exposed skin.
- Check yourself, clothing, gear, children, and pets for ticks after being in potential tick habitats and remove ticks promptly.
- Avoid drinking untreated surface water.
More information on ticks and preventing tickborne diseases can be found at https://doh.wa.gov/community-and-environment/pests/ticks.
Pets and tularemia
Domestic cats often get very sick if infected with tularemia and can also transmit the bacteria to humans. Dogs can also get infected and may be at risk for severe illness. Prevent tularemia in your pets by:
- Keeping pets under observation when outdoors and preventing contact with wildlife, particularly sick or dead wildlife and rodents.
- Using tick control products for pets as recommended by your veterinarian.
Contact your veterinarian if your pet is sick and has been in contact with wildlife.