TULAREMIA
Background:
Tularemia is a potentially serious illness that occurs naturally in the U.S. and is caused by a aerobic, gram-negative bacteria Francisella tularensis found in animals (e.g., rodents, rabbits, and hares). A small number (~10-50 organisms) can cause disease. It can survive for weeks at low temperatures in water, moist soil, hay, straw, and decaying animal carcasses.
Infection can occur via diverse environmental exposures: bites by infected arthropods; handling infectious animal
tissues/fluids; direct contact with or ingestion of contaminated food, water, or soil; and inhalation of infective aerosols. Humans can develop severe and sometimes fatal illness, but do not transmit the disease to others.
Incubation:
Average occurrence of symptoms is 3-5 days, can occur as early as the day after exposure to 3 weeks later.
Frequency of Naturally Occurring:
Direct handling of infected animals result in 75-85% of cases being ulceration of skin at point of contact (hands or fingers) and painful swollen lymph nodes with fever, chills, headache and malaise. About 5-10 % of cases do not show skin ulceration. Ingestion can occur or eyes can be infected with one-sided swelling, and signs of a weeping conjunctivitis.People who inhale an infectious aerosol would generally experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated. Inhalation may be the form if infection from a WMD Weapon of Mass Disruption. About 5-15% of naturally occurring illnesses result from inhalation and are more serious – called Typhoid Tularemia. Besides fever someone infected can be so sick as they are unable to get up to care for themselves and lose weight. The throat can be sore and develop a membrane. There is chest discomfort and non-productive cough, and pneumonia usually develops in 30-80% of Typhoid Tularemia cases and 10-15% of those with skin ulcerations or lymph nodes. The occurrence of pneumonia is 3-15 times more likely to occur than a normal flu or cold.
Survivability:
Skin-lymph node cases have a 95% survival rate (about the same rate as a normal flu-infection), and even the severe Typhoid Tularemia has a 65% survival rate.
Care Precautions:
Person-to-person spread is unusual and normal precautions (gloves, mask to prevent inhalation, hand
Treatment:
- If exposure is suspected, the physician can prescribe Cipro 500 mg twice a day for 10 to 14 days or Tetracycline 500 mg four times a day for two weeks.
- If an infection is found, the physician will prescribe Cipro intravenously or orally; or Streptomycin intramuscularly; or Gentamicin intravenously.
