Summary about Disease
Tularemia is a bacterial infectious disease caused by Francisella tularensis. It can affect various parts of the body, including the skin, eyes, lymph nodes, lungs, and other internal organs. It's a relatively rare disease but can be serious if not treated promptly. It's also known as rabbit fever, deer fly fever, and Ohara's disease.
Symptoms
Symptoms vary depending on the type of tularemia and how the bacteria entered the body. Common symptoms include:
Sudden fever: Often high, reaching 104°F (40°C)
Chills
Headache
Fatigue
Muscle aches
Swollen lymph nodes: Usually near the site of infection.
Skin ulcers: Often at the site of entry of the bacteria (e.g., an insect bite) Other possible symptoms, depending on the type of tularemia:
Oculoglandular tularemia: Eye pain, redness, and swelling; ulcers on the conjunctiva.
Glandular tularemia: Swollen, painful lymph nodes without a skin ulcer.
Ulceroglandular tularemia: Skin ulcer and swollen lymph nodes.
Pneumonic tularemia: Cough, chest pain, difficulty breathing, pneumonia.
Typhoidal tularemia: Abdominal pain, nausea, vomiting, diarrhea, and potentially multi-organ failure.
Oropharyngeal tularemia: Sore throat, mouth ulcers, difficulty swallowing.
Causes
Tularemia is caused by the bacterium Francisella tularensis. Transmission can occur through several routes:
Tick and deer fly bites: This is a common route of infection.
Contact with infected animals: Handling infected animals, especially rabbits, rodents, and hares.
Ingestion of contaminated water or food: Rare, but possible.
Inhalation of aerosolized bacteria: Can occur during activities like mowing lawns in areas where infected animals are present or in laboratory settings.
Laboratory exposure: Rare but possible for laboratory workers handling the bacteria.
Medicine Used
4. Medicine used The primary treatment for tularemia is antibiotics. Common antibiotics used include:
Streptomycin: An older but effective antibiotic, often given intravenously or intramuscularly.
Gentamicin: Another effective antibiotic, also given intravenously or intramuscularly.
Doxycycline: A tetracycline antibiotic, given orally or intravenously.
Ciprofloxacin: A fluoroquinolone antibiotic, given orally or intravenously. Treatment duration typically lasts for 10-21 days, depending on the severity of the infection and the antibiotic used.
Is Communicable
Tularemia is not typically communicable from person to person. It is primarily transmitted from animals to humans. Person-to-person transmission is extremely rare, if it occurs at all.
Precautions
Avoid tick and deer fly bites: Use insect repellent containing DEET, wear long sleeves and pants when outdoors, and check yourself for ticks regularly.
Handle animals carefully: Wear gloves when handling animals, especially wild rabbits, rodents, and hares. Wash your hands thoroughly afterward.
Cook meat thoroughly: Ensure that meat from wild game is cooked to a safe internal temperature.
Drink safe water: Avoid drinking untreated water from streams or lakes.
Wear a mask: When mowing lawns or working in areas where infected animals may be present, wear a mask to avoid inhaling aerosolized bacteria.
Educate yourself: Be aware of the risk of tularemia in your area and know how to protect yourself.
Report suspected cases: Report any suspected cases of tularemia to local health authorities.
How long does an outbreak last?
The duration of a tularemia outbreak can vary widely depending on the source of the outbreak, the number of people affected, and the effectiveness of control measures. Outbreaks can last from a few weeks to several months. Factors that influence the duration include the ability to identify and eliminate the source of infection, implement appropriate public health interventions (e.g., vector control), and provide timely treatment to affected individuals. Sporadic cases outside of defined outbreaks may occur year-round.
How is it diagnosed?
Diagnosis of tularemia involves several methods:
Clinical Evaluation: Assessing the patient's symptoms and medical history.
Blood tests: Detecting Francisella tularensis antibodies. This may involve acute and convalescent sera to show a rise in antibody levels.
Culture: Growing the bacteria from a sample of blood, wound, or lymph node tissue. However, this is not always successful and poses a risk to laboratory personnel, so it's not done routinely.
PCR (Polymerase Chain Reaction): Detecting the bacteria's DNA in a sample. This is a rapid and sensitive method.
Direct Fluorescent Antibody (DFA) testing: Used to detect the presence of F. tularensis in clinical specimens.
Timeline of Symptoms
9. Timeline of symptoms The incubation period for tularemia (the time between exposure and the start of symptoms) is typically 3 to 5 days, but it can range from 1 to 14 days. The timeline of symptoms following the incubation period can vary, but generally follows this pattern:
Days 1-3: Sudden onset of fever, chills, headache, and muscle aches.
Days 3-7: Development of skin ulcer (if ulceroglandular type), swollen lymph nodes, fatigue.
Days 7-14: Progression of symptoms if left untreated; potential for pneumonia (if pneumonic type), or systemic complications.
With antibiotic treatment: Improvement in symptoms typically begins within 24-48 hours of starting appropriate antibiotic therapy.
Important Considerations
Tularemia is a reportable disease in many countries. This means that healthcare providers are required to report suspected cases to public health authorities.
Early diagnosis and treatment are crucial to prevent serious complications and death.
Tularemia can be used as a biological weapon. Although rare, this potential risk necessitates ongoing research and surveillance.
Laboratory personnel should take special precautions when handling Francisella tularensis due to the risk of infection.
Prevention is key. Simple measures such as avoiding tick bites and handling animals safely can significantly reduce the risk of infection.