Tularemia - Symptoms, Treatment, Prevention


Tularemia, or called “rabbit fever”, is a bacterial infectious disease that can infect both animals and people. The bacterium Francisella tularensis is the pathogen of Tularemia. Rabbits, hares, and rodents are especially susceptible and often die in large numbers during outbreaks. Human can become infected in several ways, including:

  • Tick and deer fly bites
  • Skin contact with infected animals, most often a rabbit, muskrat, beaver, or squirrel
  • Drinking contaminated water
  • Breathing in contaminated aerosols or agricultural and landscaping dust
  • Laboratory exposure

Tularemia is rare, every year there’re 100-200 cases reported in the United States. Tularemia can be treated with antibiotics, some of the cases can be life-threatening.

According to CDC, tularemia has been reported from all states except Hawaii, but is most common in the south central United States, the Pacific Northwest, and parts of Massachusetts, including Martha’s Vineyard.


The signs and symptoms of tularemia vary depending on how the bacteria enter the body. Symptoms develop 3 to 5 days after exposure. The illness usually starts suddenly and may continue for several weeks.

Symptoms include:

  • Fever to as high as 104 °F
  • Chills
  • Excessive sweating
  • Eye irritation (conjunctivitis, if the infection began in the eye), swelling of lymph glands in front of the ear, as in Oculoglandular tularemia
  • Sore throat, mouth ulcers, tonsillitis, as in Oropharyngeal
  • Headache
  • Joint stiffness, muscle pain
  • Ulcers that start from red spots on skin, as in Ulceroglandular tularemia, it’s the most common form and usually occurs following a tick or deer fly bite or after handing of an infected animal
  • Shortness of breath, cough, chest pain, as in Pneumonic tularemia
  • Weight loss


Lab tests and imaging tests are commonly used to diagnose tularemia.

  • Blood culture for the bacteria
  • Blood test measuring antibodies
  • Chest x-ray
  • Polymerase chain reaction (PCR) test of a sample from an ulcer


Treatment of tularemia is antibiotics.

Streptomycin is the drug of choice.

Gentamicin is an alternative to streptomycin.

Tetracycline and chloramphenicol can be used but not usually a first choice.

Treatment usually lasts 10 to 21 days depending on the stage of illness and the medication used.

Tularemia is fatal in about 5% of untreated cases, and in less than 1% of treated cases. Treatment matters.


When hiking, camping or working outdoors, use insect repellents containing DEET or IR3535 and wear long pants, long sleeves and long socks to keep ticks and deer flies off your skin.

Drink clean water.

Stay away from sick or dead animals.

Use gloves when handling animals, especially rabbits, muskrats, prairie dogs, and other rodents.

Cook meat thoroughly before eating.


Oct 16, 2019

Stockholm University searchers predict that tularemia may become increasingly common in the future in high-latitude regions.

As the average annual temperature rises in high-latitude regions, magnitudes of rain and snow and the flow of water through the landscape also change. These changes affect living conditions, for example, for insects that may be carriers of diseases.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.