• Tularemia is also called deer-fly fever, market man disease, or rabbit fever. It is a disease found in animals such as voles, mice, water rats, squirrels, rabbits, hares, and muskrats. It may also be found in insects, birds, hamsters, and domestic cats. The disease is caused by bacteria (germ) called Francisella tularensis. Tularemia is most common in Arkansas, Missouri, Montana, Oklahoma, and South Dakota. The germ can live for weeks at low temperatures in water, moist soil, hay, straw, and dead animals. It may be passed from one animal to another or from an animal to a human. Tularemia cannot be passed from one human to another human.

  • You may have fever, chills, headache and body aches at the start of your infection. You may also have weakness, appetite loss and weight loss. Other signs and symptoms depend on how the germ entered your body. They may appear 2 to 5 days after being infected. You may need a chest x-ray, blood tests and cultures to learn more about your condition. Treatment with antibiotics should decrease your skin sores (ulcers) and prevent other complications. Treatment may also cure your infection and you may have no further problems.



  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Types of tularemia:

There are different types of the tularemia infection. All types can occur at the same time and may have overlapping signs and symptoms. You may have one or more of the following:

  • Glandular: Glands such as your lymph nodes may swell with this type of infection. This type of infection occurs from direct contact with infected animals, insects, or tools.

  • Oculoglandular: This type of infection involves the eye. This may occur by touching your eye with a contaminated finger. It may also occur when infected fluid is splashed into your eye.

  • Oropharyngeal: This type is caused by drinking infected water or eating infected foods. You may have swollen and white patchy tonsils and a sore throat. This often occurs on only one side of your mouth and throat.

  • Pneumonic: This is caused by breathing in the germ and is the most severe type of tularemia infection . The germs are usually in the air as a dust or spray. Tularemia germs that spread through your blood stream into your lungs may also cause this type of infection.

  • Typhoidal: This type of infection may cause severe (very bad) illness. It is usually caused by breathing in the germ, but may have an unclear site of germ entry.

  • Ulceroglandular: This is the most common type of tularemia and results from contact with infected animals, insects, or tools. You will have a sore or sores on your body that are normally seen on your hand first. Lymph nodes found in the same area of your body where you have sores may also be swollen.

Problems that may come with tularemia:

Ask your caregiver for more information about the following conditions:

  • Blood problems:

    • Disseminated intravascular coagulation: This is also called DIC. This happens when the blood clotting agents (platelets and certain proteins) in your blood become over-active. This condition may cause serious problems with bleeding or blood flow.

    • Sepsis: This is a severe blood infection that may lead to confusion (trouble thinking clearly), coma or even death.

  • Inflammation: This is when your body tissues or organs become inflamed (swollen). Inflammation may occur in your liver, the lining of your heart chambers, and the tissue covering your brain.

  • Other body problems:

    • Kidney failure: Your kidneys work to remove toxic (harmful) substances in your blood through your urine. When one or both of your kidneys are damaged, harmful substances (things) remain inside your body.

    • Pneumonia: This is a lung infection which may make it hard for you to breathe. Severe pneumonia may cause your lungs to fail, and may lead to death. An abscess (pus pocket) may also form in your lungs with pneumonia.

    • Skin problems: Problems with your skin may include erythema nodosum or erythema multiforme. These conditions may cause small red nodules (lumps) or sores on your legs and arms.

Preventing tularemia:

  • Ask your caregiver about having vaccines against tularemia. The vaccine may only be given to those at risk of being directly exposed to the germ. The vaccination may help, but is not a guarantee of protection from the tularemia germ. Ask your caregiver for more information about the vaccine.

  • Avoid handling or being around sick animals. If avoiding the animal is not possible, use a mask to prevent you from inhaling any germs.

  • Clean anything that comes into contact with the germs thoroughly. Wash your contaminated hands or body areas with soap and water. Tools that have been used on an infected animal should also be cleaned carefully. Use bleach or alcohol to kill the germs and prevent them from spreading.

  • Drink safe water and cook your food well. Only use water from protective wells. Avoid drinking water from sources that you think may not be safe. Always cook your food thoroughly.

  • Remove ticks when you have them. Ticks may come from infected animals and may be seen in humans. Once you see a tick, remove it from your body immediately to decrease your risk of infection. You may also use an insect repellant to prevent infected insects from biting you.

  • Wear protective clothing. Those who are in direct contact with wild rodents or other animals should always wear gloves. Wear clothing that protects you from contact with sick animals. Protective clothing may also be used when cutting bushes or mowing grass. Protective clothing may also prevent infected insects from biting you.

For more information:

Contact the following:

  • Centers for Disease Control and Prevention (CDC)
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 800 - 232-4636
    Web Address: http://www.cdc.gov/


  • You have a fever.

  • You cannot think clearly.

  • You have a rash on your body.

  • You have body weakness.

  • You have questions or concerns about your condition, treatment, or care.


  • You have fainted (passed out).

  • You have severe chest pain.

  • You suddenly have trouble breathing.

  • Your symptoms do not improve even after taking medicines.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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