Tularemia is an uncommon but potentially fatal zoonotic disease caused by the gram-negative coccobacillus Francisella tularensis.
Approximately 40% of all tularemia cases reported to CDC each year occur in Arkansas, Oklahoma, and Missouri. To define the epidemiologic and clinical features of tularemia in Missouri, the Missouri Department of Health and Senior Services (MDHSS) analyzed surveillance data and conducted a retrospective clinical chart review of cases that occurred during 2000--2007.
This report describes the results of that analysis, which identified 190 cases (87 confirmed and 103 probable), for an average annual incidence of 0.4 cases per 100,000 population statewide. Most cases occurred during the summer months (78%) and among males (66%).
Analysis of 121 clinical charts revealed that children were more likely than adults to be diagnosed with glandular tularemia, whereas adults were more likely to be diagnosed with pneumonic tularemia.
Sixty-three (52%) patients were hospitalized; one patient died. Among 78 cases with a documented exposure source, 72% were associated with tick bite. In 33 (85%) of 39 culture-confirmed cases, the laboratory received specimens without any indication of suspicion of a tularemia diagnosis.
Clinicians should 1) be aware of the range of tularemia symptoms, 2) consider the diagnosis in patients reporting fever and tick or animal exposure, and 3) initiate empiric antimicrobial therapy while awaiting laboratory confirmation.
Laboratory staff should take appropriate precautions when processing culture specimens from tularemia-endemic regions, even if suspicion of tularemia is not noted when the specimen is submitted.
Posts: 7052 | From Colorado | Registered: Mar 2003
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96220 | From Texas | Registered: Feb 2001
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Melanie Reber
Frequent Contributor (5K+ posts)
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posted
Hey Miss Tootsie-Pops! I'm so sorry... but MO seems to be a really active hot spot recently for TBDs, please be cautious, OK? We love you toooo much to see you ill again!
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Melanie Reber
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Member # 3707
posted
Tularaemia after tick exposure - typical presentation of rare disease misdiagnosed as atypical presentation of common diseases: a case report Karolina Switaj, Maria Olszynska-Krowicka, Hanna Zarnowska-Prymek, Piotr Zaborowski Received: 25 May 2009 Accepted: 9 July 2009 Published: 31 July 2009 Cases Journal 2009, 2:7954 doi: 10.4076/1757-1626-2-7954 This article is available from: http://casesjournal.com/casesjournal/article/view/7954
Abstract
A 44-year-old female was admitted because of tender, enlarged inguinal lymph nodes with a history of tick bite five weeks earlier. In the place of a tick bite on the skin a small ulcer was present. The primary symptoms before admission suggested typical diseases related to tick bite such as Lyme borreliosis and tick-borne encephalitis, what corresponded with positive IgM ELISA test for Lyme borreliosis. The course of disease however clarified the diagnosis of tularaemia, which is a relatively rare disease in Poland (6 cases per 40 million population are reported annually). The ultimate diagnosis was confirmed by serological tests.
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linky123
Frequent Contributor (1K+ posts)
Member # 19974
posted
They also call tularemia 'rabbit fever' around here.
A member of our church almost died of it before they figured out what was wrong with him.
My cat regularly drags dead rabbits up to the back door.
We always use latex gloves, and dispose of them carefully in ziploc bags.
You can even get it from inhaling the bacteria.
I always put a mask over my mouth and nose when cleaning up kitty's little gifts.
Then clean the spot where the rabbit was with Clorox.
Some, not all rabbits do carry the disease.
I've heard even rodents and birds can carry it.
Linky
Posts: 2607 | From Hooterville | Registered: Apr 2009
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
I'm so pleased you are taking precautions Linky. This disease should not be taken lightly.
A bit more information:
Tularemia
Tularemia is caused by the bacterium Francisella tularensis. It is a highly infectious, invasive and potentially dangerous pathogen. So much so that the CDC has it listed as a possible bio-weapon.
Tularemia has many modes of transmission. Typically, contraction occurs with the bite of an infected vector such as the deerfly, the horsefly, the mosquito, the flea or the tick (Amblyomma americanum, Amblyomma maculatum, Argasidae Otobius megnini, Haemaphysalis leporispalustris, Ixodes pacificus, Ixodes Dermacentor andersoni, Ixodes Dermacentor occidentalis and Ixodes Dermacentor variabilis). In addition, it is transmitted through contaminated water, food and soil.
Handling infected animals and ingesting infected game puts many at risk. Organisms can be transmitted directly through a bite from pets and wild animals, such as raccoons, snakes, and coyotes, which have bitten a sick or dead rabbit and thus have the bacteria in their mouths. Tularemia has also been acquired through inhalation of airborne particulates.
Tularemia is classified as a Category A disease/agent. The fatality rate is 5-15% in untreated patients, and when spread by aerosol, the rate increases to 30-60%.
F. tularensis: an arthropod-borne pathogen. Petersen JM, Mead PS, Schriefer ME Vet Res 2008 Oct 28; 40(2):7.
Tularemia transmitted by insect bites--Wyoming, 2001-2003. MMWR Morb Mortal Wkly Rep 2005 Feb 25; 54(7):170-3.
A small water-borne tularemia outbreak. Meri� M, Sayan M, Willke A, Gedikoğlu S. Mikrobiyol Bul 2008 Jan; 42(1):49-59.
Two unusual glandular presentations of tick-borne tularemia. Charles P, Stumpf P, Buffet P, et al. Med Mal Infect 2008 Jan 9.
An outbreak of airborne tularaemia in France, August 2004. Siret V, Barataud D, Prat M, et al. Euro Surveill 2006 Feb 20; 11(2)
Tularemia outbreak in the province of Cuenca associated with crab handling. D�az de Tuesta AM, Chow-Quan , Geijo Mart�nez MP, et al. Rev Clin Esp 2001 Jul; 201(7):385-9
A milk-borne outbreak of tularemia in Moscow. Manenkova GM, Rodina LV, Tsvil' LA, et al. Zh Mikrobiol Epidemiol Immunobiol 1996 Sep-Oct; (5):123-4.
Detection of diverse new Francisella-like bacteria in environmental samples. Barns SM, Grow CC, Okinaka RT, et al. Appl Environ Microbiol 2005 Sep; 71(9):5494-500.
Tularemia associated with a hamster bite--Colorado, 2004. MMWR Morb Mortal Wkly Rep 2005 Jan 7; 53(51):1202-3.
First reported prairie dog-to-human tularemia transmission, Texas, 2002. Avashia SB, Petersen JM, Lindley CM, Schriefer ME, Gage KL, Cetron M, et al. Emerg Infect Dis 2004 Mar
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