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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 deer flies 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 cook meat to the right temperature — a minimum of 160 F (71.1 C) for pork and ground meat and game meat, 145 F (62.8 C) for farm-raised steaks and roasts — to make it safe to eat.
References
- Tularemia. Centers for Disease Control and Prevention. http://www.cdc.gov/tularemia/index.html. Accessed May 4, 2012.
- Longo DL, et al. Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9122226. Accessed May 4, 2012.
- McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed May 4, 2012.
- Graham J, et al. Tick-borne illnesses: A CME update. Pediatric Emergency Care. 2011;27:141.
- Snowden J, et al. Tularemia: Retrospective review of 10 years' experience in Arkansas. Clinical Pediatrics. 2011;50:64.
- Conlan JW. Tularemia vaccines: Recent developments and remaining hurdles. Future Microbiology. 2011;6:391.
- Safe minimum cooking temperatures. FoodSafety.gov. http://www.foodsafety.gov/keep/charts/mintemp.html. Accessed May 15, 2012.
- Game from farm to table. USDA Food Safety and Inspection Service. http://www.fsis.usda.gov/fact_sheets/farm_raised_game/index.asp. Accessed May 15, 2012.
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