A highly infectious disease caused by a bacterium called F. tularensis is called Tularemia. This bacteria can pass to humans through bug bites, infected animals, contaminated food or water, and inhaling the particles of bacteria from the air. While this condition can affect the skin and eyes, it may also impact the lungs, intestines, and throat. Immediate treatment is very important to prevent serious and even life-threatening complications. In most cases, tularemia is treated with antibiotics.
Furthermore, this is a zoonotic disease that causes the lymph nodes to swell painfully. However, it may cause other symptoms, but it depends on which part of the body is affected. It may also cause broken skin (also known as ulceration) at the site where bacteria have entered the body. While most people get this bacteria from exposure to deer flies and ticks, they may also get it from infected animals (including rabbits, hares, and rodents).
When this bacterium enters the body, they are eaten by the immune system cells. In normal circumstances, these cells would kill these bacteria, but in such cases, they begin to grow and multiply in the immune system cells. Thus, these infected cells travel throughout the body. The symptoms occur due to the response of the immune system to the infected cells.
In general, this is a rare condition because it affects about 300 people every year in the U.S. Mostly, it occurs in the south-central United States, the Great Plains region, and parts of Massachusetts.
Types of Tularemia
Healthcare professionals have categorized this condition into several types, depending on the way to get infected and the symptoms you experience. Check below some examples:
- Ulceroglandular tularemia – This is one of the most common types of tularemia, and it often occurs through a tick or infected animal bite. Usually, it negatively affects the skin and lymph nodes.
- Glandular tularemia – This type of tularemia is very similar to the previous type, but it affects the lymph nodes only. You may get glandular tularemia from a tick bite or directly from an infected animal.
- Oculoglandular tularemia – You can get this type of tularemia from contaminated water or body fluids in the eye. Usually, it causes eye infection and affects only one eye.
- Oropharyngeal tularemia – This type occurs due to contaminated food or water or when touching contaminated surfaces and then your eyes, nose, or mouth. Most people who get oropharyngeal tularemia experience sore throat and gastrointestinal symptoms (sometimes).
- Pneumonic tularemia – This is one of the most serious forms of tularemia because it negatively affects the lungs. The symptoms of pneumonic tularemia are very similar to pneumonia. Usually, people get this type of tularemia in 2 ways: by breathing particles of bacteria or when F. tularensis spreads to the lungs from other parts of the body.
- Typhoidal tularemia – This type causes a high fever and may impact several parts of the body at the same time.
Symptoms
In most cases, this condition causes fever and rash. However, you may also experience additional symptoms depending on the type and severity of tularemia. Check below some examples:
Ulceroglandular and Glandular Tularemia Symptoms
- Fever
- Large, swollen, and painful lymph nodes
- Open wounds (ulcers or lesions) on the skin
However, open sores can occur only in people who develop ulceroglandular tularemia.
Oculoglandular Tularemia
These include:
- Eye pain
- Watery eyes
- Increased sensitivity to light (photophobia)
- Painful lymph nodes around the neck and ears
- Corneal ulceration (open sores on the eye)
Oropharyngeal Tularemia Symptoms
- Fever
- A severe form of sore throat
- Red and swollen throat with white patches
- Vomiting
- Diarrhea (sometimes it can be bloody)
- Abdominal (belly) pain
Pneumonic Tularemia Symptoms
- Muscle aches
- Dyspnea (shortness of breath)
- Cough
- Fever
- Erythema nodosum (red bumps or rash)
- Hemoptysis (coughing up blood)
- Chest tightness or pain
Typhoidal Tularemia Symptoms
- High fever
- Chills
- Headaches
- Appetite changes
- Sore throat
- Pain in the abdomen (belly)
- Nausea
- Vomiting
- Diarrhea
- Confusion
If you experience any of the previous symptoms, do not hesitate to visit a doctor.
Causes
This infectious disease occurs when a bacterium called F. tularensis enters the body. This bacterium lives in rabbits, hares, rodents, and cats. It may also spread to humans through bites from ticks or other insects that may carry this bacterium. In general, there are two types of F. tularensis bacterium, such as types A and B. While type A is mostly diagnosed in the U.S., type B is usually found in North America and other parts of the world. Moreover, people who get F. tularensis type B usually experience mild symptoms. Check below some ways in which the bacterium spreads:
- Bites from deer flies, mosquitoes, ticks, and other insects
- An infected animal bite
- Touching infected animals and then your eyes, nose, or mouth without washing your hands
- Drinking or eating contaminated water or food
- Inhaling particles of this bacterium from the air
Furthermore, while cooking meat to a safe temperature of an infected animal can kill this bacterium, it is not recommended to eat an animal that has had tularemia.
In addition, this is not contagious. In any case, there is no evidence that it can spread directly from one person to another. A highly contagious disease means that even a small amount of bacteria can make you get sick.
Risk Factors
While anyone can get this condition, some people are at increased risk of developing tularemia because of their work, hobbies, or other aspects of their life. Usually, you are at increased risk of developing this infectious disease if:
- Handle uncooked meat
- Work as a veterinarian
- Continuously around biting insects
- Weakened immune system (which is often caused by HIV infection, cancer, immunosuppressants, and others)
- Farm workers
- Live or travel in the central park of the U.S. In most cases, tularemia is reported in Arkansas, Oklahoma, Missouri, Nebraska, South Dakota, and Kansas
What Are The Potential Complications of Tularemia?
Those who develop tularemia may also experience some complications, especially if they do not get treatment. In most cases, the following complications occur in connection with pneumonic or typhoidal tularemia. Check below some examples:
- Acute respiratory distress syndrome (ARDS)
- Heart inflammation (including myocarditis, pericarditis, or endocarditis)
- Inflammation of the brain (such as meningitis or meningoencephalitis)
- Hepatitis (liver inflammation)
- Kidney failure
- Hemorrhage (internal bleeding)
- Bone marrow, bone, or joint inflammation (osteomyelitis or arthritis)
This article does not contain a complete list of complications. However, you can consult with your healthcare professional about ways to reduce the risk or prevent previous complications.
How to Prevent Tularemia?
While it is not possible to prevent this condition, you can take steps to reduce the risk of developing it. Check below some examples:
- You should wear clothing that covers the skin as much as possible, especially when outdoors in long grass or wooded areas. Use a bug spray with DEET.
- It is also recommended to check yourself and your pets for ticks or bugs after being outside.
- Discuss with a veterinarian about ways to prevent ticks on your pets.
- You should always supervise your pets when outdoors.
- Wear gloves and a face mask when handling animals (living or dead). However, it is recommended to wash your hands with soap and water.
- It is advised to cook meat at safe temperatures to destroy this bacterium. In any case, you should not eat the meat of an infected animal.
- If you suspect you have been exposed to this bacterium, immediately contact your healthcare professional.
- Wear a mask while using a mower or other agricultural equipment.
Diagnosis
First, doctors will perform a physical examination to check for abnormalities linked to the disease. They may also ask some questions about the symptoms and medical history. However, to confirm tularemia, physicians may perform some tests. Check below some of them:
- Blood tests – These tests are often done to check for the bacterium that causes tularemia. Usually, doctors may perform a blood test after treatment, to make sure you no longer have this bacteria.
- Biopsy – During this procedure, doctors will take a small sample of tissue for testing under a microscope. It helps identify this bacterium.
- Nasal or throat swab – This test involves a long stick with a swab to get a sample of mucus from the nose or throat for testing.
- Pleural fluid test (thoracentesis) – This test is often performed in people who have fluid buildup around the lungs. Doctors may take a small sample for testing to check for the bacterium.
Treatment
The best treatment for people with tularemia is broad-spectrum antibiotics that can be given through an injection or oral medicines. Without immediate treatment, a person with tularemia may experience serious or even life-threatening complications. Check below some antibiotics often prescribed by doctors for people with tularemia:
- Streptomycin
- Gentamicin
- Doxycycline
- Azithromycin
- Ciprofloxacin or Levofloxacin
It is very important to finish the treatment with antibiotics exactly as recommended by your doctor, even if you do not have symptoms. Otherwise, the condition may return. Furthermore, physicians may also recommend over-the-counter (OTC) medications and other therapies to relieve more severe symptoms.
Frequently Asked Questions
Is tularemia like Lyme disease?
Many symptoms caused by tularemia are similar to Lyme disease. However, these conditions affect the body differently. While tularemia may affect multiple parts of the body and can be life-threatening, Lyme disease is not dangerous, but it causes chronic symptoms that are hard to treat.
Is tularemia curable in humans?
Yes, it can be cured with antibiotics. However, it is very important to get treatment as soon as possible to prevent life-threatening complications.
How long does tularemia last?
This condition often lasts for 2-3 weeks, but it may take longer in severe cases. Sometimes, people with tularemia may develop permanent scars on the skin. Ask your healthcare professional if you have additional questions.
