Tularemia: Symptoms, Causes, Treatment

What are the symptoms of tularemia?

Tularemia is an infectious disease caused by the bacterium Francisella tularensis. The symptoms can vary depending on the form of the disease, but common symptoms include:

• Ulceroglandular Tularemia: This is the most common form and involves a skin ulcer at the site of infection, along with swollen and painful lymph nodes.
• Glandular Tularemia: Similar to ulceroglandular, but without the skin ulcer. It involves swollen lymph nodes and fever.
• Oculoglandular Tularemia: This form affects the eyes, causing symptoms such as conjunctivitis (pink eye), eye pain, and swelling of the lymph nodes near the eyes.
• Oropharyngeal Tularemia: This form affects the throat, leading to symptoms like sore throat, mouth ulcers, and swollen lymph nodes in the neck.
• Pneumonic Tularemia: This form affects the lungs and can cause symptoms such as cough, chest pain, difficulty breathing, and fever.
• Typhoidal Tularemia: This is a severe form that affects multiple organs and may cause high fever, abdominal pain, and a general feeling of illness.
• Systemic Tularemia: This form can lead to a wide range of symptoms including fever, chills, weakness, and potentially severe complications affecting various organ systems.

The symptoms usually appear 3 to 5 days after exposure to the bacteria, but the incubation period can range from 1 to 14 days. If tularemia is suspected, prompt medical attention is necessary for proper diagnosis and treatment.

What are the causes of tularemia?

Tularemia is caused by the bacterium Francisella tularensis, which can be transmitted to humans through various routes. The main causes include:

• Insect Bites: The most common way tularemia spreads is through the bite of infected ticks, deer flies, and other insects.
• Direct Contact with Infected Animals: Handling or skinning infected animals, especially small mammals like rabbits, hares, and rodents, can lead to infection. Hunters are particularly at risk.
• Inhalation: Breathing in dust or aerosols contaminated with F. tularensis can lead to pneumonic tularemia. This can occur when mowing or landscaping in areas where infected animals have been present.
• Contaminated Food or Water: Ingesting contaminated water, undercooked meat, or unwashed fruits and vegetables can result in oropharyngeal tularemia.
• Laboratory Exposure: Workers handling F. tularensis in laboratory settings are at risk if proper safety measures are not followed.

Tularemia is not spread from person to person, so direct human contact is not a cause of transmission. The risk factors are largely environmental and related to exposure to vectors, animals, or contaminated materials.

What is the treatment for tularemia?

Tularemia is treated primarily with antibiotics. The choice of antibiotic and duration of treatment depend on the form and severity of the infection. The key treatments include:

• Streptomycin: This is considered the most effective antibiotic for treating tularemia and is often the first choice. It is usually administered via injection.
• Gentamicin: Another common treatment, particularly for patients who may not tolerate streptomycin. Gentamicin is also administered by injection.
• Doxycycline and Ciprofloxacin: These antibiotics are effective in treating mild to moderate tularemia cases and can be taken orally. They are often used when injection therapy is not feasible or for longer courses of treatment following initial injectable antibiotics.
• Other Supportive Care: Depending on the severity of the disease, additional treatments might include managing symptoms such as fever, dehydration, and other complications.

Early treatment is crucial for preventing severe complications and ensuring a good prognosis. Most cases respond well to appropriate antibiotic therapy.