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Causes
By Mayo Clinic staffTularemia doesn't occur naturally in humans and isn't known to pass from person to person. However, tularemia occurs worldwide, especially in rural areas, because many mammals, birds, insects and fish are infected with F. tularensis. The organism can live for weeks in soil, water and dead animals.
Unlike some infectious diseases that spread from animals to people through a single route, tularemia has several modes of transmission. How you get the disease usually determines the type and severity of symptoms. In general, you can get tularemia through:
- Insect bites. Although a number of insects carry tularemia, ticks and deerflies are most likely to transmit the disease to humans. Tick bites cause a large number of cases of ulceroglandular tularemia.
- Exposure to sick or dead animals. Ulceroglandular tularemia can also result from handling or being bitten by an infected animal, most often a rabbit or hare. Bacteria enter the skin through small cuts and abrasions or a bite, and an ulcer forms at the wound site. The ocular form of tularemia can occur when you rub your eyes after touching an infected animal.
- Airborne bacteria. Bacteria in the soil can become airborne during gardening, construction or other activities that disturb the earth. Inhaling the bacteria can lead to pneumonic tularemia. Laboratory workers who work with tularemia also are at risk of airborne infection.
- Contaminated food or water. Although uncommon, it's possible to get tularemia from eating undercooked meat of an infected animal or drinking contaminated water. The signs include vomiting, diarrhea and other digestive problems (oropharyngeal tularemia). Heat kills F. tularensis, so well-cooked meat — at least 160 F (71 C) — is usually safe to eat.
- Frequently asked questions (FAQ) about tularemia. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/agent/tularemia/faq.asp. Accessed Feb. 15, 2010.
- Nigrovic LE, et al. Tularemia. Infectious Disease Clinics of North America. 2008;22:489.
- Everett. ED. Clinical manifestations, diagnosis, and treatment of tularemia. http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2010.
- Everett ED. Microbiology, pathogenesis, and epidemiology of tularemia, http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2010.
- Eisen RJ, et al. Ecoepidemiology of tularemia in the Southcentral United States. American Journal of Tropical Medicine & Hygiene. 2008;78:586.
- Tularemia: Surveillance reported cases by state. Centers for Disease Control and Prevention. http://www.cdc.gov/tularemia/Surveillance/Tul_CasesbyState.html. Accessed March 2, 2010.
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