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» LymeNet Flash » Questions and Discussion » Medical Questions » URGENT Looking for People with TULAREMIA

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Author Topic: URGENT Looking for People with TULAREMIA
citruslyme
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I just recently saw an Id doc and we are considering the possiblility of tularemia aka rabbit fever.

cats can spread it to humans via anthropd bites and it is also a tick disease.

I am looking for anyone who has lyme and tularemia or had tularemia and any support groups.

I am thinking of maybe doing US testing as it is far better and need help on finding a good lab that tests for it.

If anyone has any information on this please let me know or PM.
thank you. help is appreciated

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citrus

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citruslyme
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Up for help please.
If anyone knows anyone with tularemia could you please PM me.
Also I am looking for a reputable US lab to get this test done.
thank you

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citrus

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tailz
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I just had one drawn on Monday - but I don't have my results yet.

Quest did it - they drew 3 sets of blood cultures - 10 minutes apart.

We'll see. I have cats, plus I took care of some baby bunnies that kept being born in my yard.

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citruslyme
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Tailz,
last summer my mom and I fell deathly ill and are still searching for answers.
Tularemia is as close as it can get.
many stray cats moved into our yard last summer and our cat hung around them.
we live enxt to a creek with wildlife.
Many rabbits were born last spring, it is a record.
thye are everythwhere.
My cat was very ill and barely made it himself.
he hAs some sx similar to us.
We are doing a Canadian test here in Canada.
But I am skeptical as many tick disease tests are flawed.
could you Pm me and give me more info on Quest.
what is their website or phone number
how much is the testing
would I be able to send my blood to them via fed ex just like I did to Igenex
p.s what are your sx
thanks

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citrus

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Jill E.
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I know two people here in Southern California who had it along with Lyme and other TBDs and have treated it. They do not post on Lymenet. I'll see what I can find out for you. It may take a few days for me to get answers back. I know one person had to use some sort of injected antibiotic.

Two wild bunnies in the town just next to mine tested positive for Tularemia - this was not too much before I was bitten by the tick, so it's a concern for me, too. I have not yet been tested, but Quest is the lab. You can call Quest directly to discuss shipping requirements from Canada.

Jill

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If laughter is the best medicine, why hasn't stand-up comedy cured me?

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citruslyme
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HI Jill Im cocnerned what impacts it will have in combo with the lyme........how are the people coping with both, did it make the lyme mroe agressive
also do you quests phone number so I could call them.
thanks

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citrus

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Tincup
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I'd look at Bartonella.

To get information for Quest.. simply look it up on the web. There are many offices and draw stations across the country... so you will need to check it out by location.

Information that may help:


Q. What is tularemia?
A. Tularemia is an infection of animals and humans caused by the bacterial organism
Francisella tularensis. There are two different biovars (strains) of F. tularensis:
biovar tularensis, the primary type found in North America, is highly virulent and
results in serious illness, while biovar palearctica is less virulent and produces
milder symptoms. Tularemia is sometimes called rabbit fever or deer fly fever.

Q. How prevalent is tularemia?
A. Tularemia occurs throughout North America, Europe, the former Soviet Union, China and Japan. Worldwide, there are
approximately 500,000 cases per year. In the United States, tularemia is reported during every month of the year for an annual total of
100-300 cases. Typically, the highest numbers of cases occur in the Midwest, particularly in Oklahoma, Arkansas, and Missouri.

Q. How does a person get tularemia?
A. There are many routes of exposure to F. tularensis: penetration of the skin or mucous membranes (e.g., when handling the
carcasses of infected animals, especially rabbits); being bitten by an infected tick or fly (especially deer flies); eating insuffic iently cooked meat from infected animals (rabbit meat can remain infective even after being frozen for several years); drinking contaminated
water; or by inhaling aerosolized bacteria (e.g. dust from contaminated soil or particles from laboratory samples).

F. tularensis is considered a potential bioterrorism agent because of the highly infectious nature of aerosolized organisms. Person-to-person transmission has not been reported.

Q. What kinds of arthropods can transmit F. tularensis?
A. Ticks are the most common arthropod source of transmission, and they include the wood tick, Dermacentor andersoni, the
American dog tick, D. variabilis, and the lone star tick, Amblyomma americanum. Less commonly, tularemia has been associated with
the bite of the deer fly Chrysops discalis, and in Sweden, the mosquito Aedes cinereus. Flies can be infective for 14 days, and ticks
throughout their lifetime.

Q. How serious is tularemia?
A. The severity of symptoms depends on the type of infecting strain of F. tularensis, the size of the exposure dose (number of bacteria
introduced), and the route of introduction (inhalation, arthropod bite, skin contact, ingestion). If left untreated, the case fatality rate can reach 5%-15%.

Q. What are the symptoms of tularemia?
A. Symptoms vary widely and begin 1-10 days (usually 2-4) following infection. In those cases where a person becomes infected by
skin contact, for example by handling an infected animal carcass, symptoms can include a slow-growing ulcer at the site where the
bacteria entered the skin (oftentimes on the hand) and swollen lymph nodes. This is known as ulceroglandular infection and it is the
most common form of tularemia, accounting for over 80% of cases.

The ulcer begins as a red, itchy bump that slowly enlarges and then ulcerates. Occasionally, no ulcer forms and lymph node enlargement may be the only sign of infection.

Those who ingest the bacteria may report a sore throat, abdominal pain, diarrhea and vomiting. If the bacteria are inhaled, a pneumonia -like illness can follow. This is usually the most damaging route of infection.

However, pneumonia may also be a complication of tularemia that is acquired via any of the routes of infection. Other symptoms of tularemia may include abrupt onset of fever (sometimes high: 103-104 o F), headache, chills, extreme weakness or exhaustion, muscle pain, drenching sweats, dry cough, delirium, and septicemia
(infection throughout the blood stream). The disease may resemble typhoid fever.

Q. How is tularemia diagnosed?
A. Tularemia should be considered as a possibility for any patient who has an unexplained fever and has had recent exposure to ticks, biting flies, rabbits, or animal tissue in a geographic area where the disease is known to exist.

Diagnosis is usually made based on
clinical symptoms and supported by blood tests that show a rising antibody titer to F. tularensis. Blood tests usually become positive
during the second week of illness. The blood of patients with brucellosis may cross-react with F. tularensis antigens, causing a false
positive result; however, antibody titers are usually much lower for brucellosis infections than for tularemia.

Isolation of the organism from an ulcer, lymph node, or sputum is confirmatory for tularemia, but this is not routinely attempted due to the danger of exposure for laboratory personnel. In addition, biopsy of infected lymph nodes must be performed with extreme care because of the likelihood for inducing septicemia in the patient as a result of bacteria released during the procedure.


Q. What is the treatment for tularemia?
A. Streptomycin is the drug of choice. Gentamicin is also effective. Therapy should continue for at least 7-14 days. Tetracycline and
chloramphenicol may also be used, but relapses occasionally occur. F. tularensis is also susceptible to 3 rd generation cephalosporins
(cefotaxime or ceftriaxone).

When diagnosis is initially unclear, but tularemia is suspected, these cephalosporins may be administered in combination with streptomycin or gentamicin. Highly virulent organisms that are resistant to streptomycin have been reported.

Q. Does past infection with F. tularensis make a person immune?
A. One episode of tularemia generally confers long-term immunity; however, reinfection has been reported.

Q. What can I do to reduce my risk of becoming infected with F. tularensis?
A. Follow these precautions to help prevent tularemia:

� Wear rubber gloves when skinning or handling animals, especially rabbits.

� Cook meat from wild game, especially rabbits and rodents such as squirrels, thoroughly before eating.

� Instruct children not to handle any sick or dead animals.

� Avoid drinking untreated water.

� Avoid the bites of ticks and flies by using protective clothing and insect repellents, and by checking for ticks frequently, as
described below:

� Wear proper clothing as a physical barrier against ticks and biting flies - long pants tucked into boots or tightly-woven socks;
long sleeve shirt; shirt tucked into pants; and light-colored clothing so as to more easily spot ticks.

� Check your skin and clothing periodically for ticks. Remove any attached ticks from your skin as soon as they are discovered.
Exercise caution during removal as body fluids and feces from infected ticks can be contaminated with F. tularensis.

� Use both skin and clothing repellents that have been approved by the Environmental Protection Agency (EPA). They are safe
and effective.

� For your skin, use a product that contains 20-50% DEET (N,N-diethyl-meta-toluamide). DEET in higher concentrations is
no more effective.

� Use DEET sparingly on children, and don't apply to their hands, which they often place in their eyes and mouths.

� Apply DEET lightly and evenly to exposed skin; do not use underneath clothing. Avoid contact with eyes, lips, and broken
or irritated skin.

� To apply to your face, first dispense a small amount of DEET onto your hands and then carefully spread a thin layer.

� Wash DEET off when your exposure to ticks, biting flies, and other arthropods ceases.

� For your clothing, use a product that contains permethrin. Permethrin is available commercially for use on clothing as
0.5% spray formulations.

� Permethrin should only be used on clothing, never on skin.

� When using any insect repellent, always FOLLOW LABEL DIRECTIONS.

� Do not inhale aerosol formulations.

� For optimum protection, soldiers should utilize the DOD INSECT REPELLENT SYSTEM. In addition to proper wear of the battle
dress uniform (BDUs)(pants tucked into boots, sleeves down, undershirt tucked into pants), this system includes the concurrent use
of both skin and clothing repellents that are available in the military supply system:

� Standard military skin repellent: 33% DEET lotion, long-acting formulation, one application is effective for up to 12 hours, NSN 6840-01-284-3982.

� Standard military clothing repellents, either: aerosol spray, 0.5% permethrin, one application remains effective through 5-6 washes, NSN 6840-01-278-1336; or impregnation kit, 40%
permethrin, one application remains effective for the life of the uniform (at least 50 washes), NSN 6840-01-345-0237.

� Keep lawns well mowed to reduce favorable tick habitat.

� Keep yard clear of brush, weeds, and woodpiles to discourage feeding and nesting of wild mammals that may carry ticks.

� Groom pets to prevent ticks from being transported into the home.

� Laboratory personnel should follow Biosafety Level 2 precautions when processing human specimens; however, all work with
cultures should be performed at Biosafety Level 3.

[Big Grin]

--------------------
www.TreatTheBite.com
www.DrJonesKids.org
www.MarylandLyme.org
www.LymeDoc.org

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tailz
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Here is info on Quest Diagnostics so you can contact them and ask:

http://tinyurl.com/2czj6d

I PM-d you, too.

I HANDLED baby bunnies, so anything is possible. I even have pictures of me and my daughter holding them somewhere. She has been back and forth too with symptoms, but she doesn't believe me even that her 2 Lyme bands mean something.

By the way, the wild bunnies I cared for had fleas. I didn't think twice about them, as long as they weren't in my house.

Oh - one baby bunny died in my pocket. He wouldn't eat, and I kept trying to forcefeed him with a syringe. The mother didn't come back after my dog got at the nest, and coincidentally, my dog got really sick, too. I had to have her put down after a year of antibiotics - symptoms similar to mine, but at least I could euthanize her.

I don't know if you have tularemia, but I'll tell you this - I looked a heck of a lot sicker than even most people with Lyme. AND they had to stop infusions after less than one week due to sky high liver enzymes.

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tailz
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One more thing - I'm not sure if ID docs in Canada are as bad as the ones here in the US.

You might want to ask on the forum here.

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Jill E.
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Hi again,

While I'm waiting to hear back from my two friends with Tularemia, I do want to say that Tincup's information is very consistent with what one of them went through: bitten by biting fly, ulceration at the bite that kept coming back. I believe she used Gentamicin (but am waiting to hear back) which has the advantage of also treating Bartonella.

Jill

--------------------
If laughter is the best medicine, why hasn't stand-up comedy cured me?

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citruslyme
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ok thanks help is appreciated

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citrus

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