Tularaemia is a disease described in 1917 in California. It shows under several forms, some of them being serious and even deadly in 1 % of the cases.

The disease starts after 3 to 15 days of incubation by high fever, shiver, extreme tiredness, and headaches. Pains in muscles and articulations, nauseas and vomiting are sometimes possible.

Clinical forms that develop depend on the contamination mode: ganglions abscess, conjunctives, dry cough that can lead to respiratory distress, abdominal pains, diarrhoeas, headaches and vomiting which can lead to coma. The disease makes progress on a period between 7 and 14 days.

Bacteriological agent

Tularaemia is due to the bacteria “Francisella tularensis” of which three sub-species exist. The “francisella tularensis holartica” is the only sub-species present in Europe. The “tularensis”, a lot more serious, is present in North America and in the south of Russia. The “mediasiatica”, weakly pathogenic is present in Central Asia and partly in Russia.

Contamination mode

There is no direct transmission of tularaemia from one person to another. Transmission can take place by inhalation of contaminated dust, by insect bites, by direct contact with contaminated water, by blood or contaminated animal carcasses and by ingestion of water or insufficiently cooked meat coming from contaminated animals.

Vectors of the disease are mainly small wild mammals like rodents (meadow mice, field mice, squirrels, muskrats) and lagomorph’s (hares). Wild boars, cats, dogs and foxes can also be vectors.

Direct contamination can take place:

• By skin contact, through sane skin, even in the absence of wound
• By respiratory tract
• By digestive tract
• By conjunctival tract

Incidence

Tularaemia cases are more frequent at the beginning of winter, during the season of rabbit hunting and during summer when ticks are numerous.

Professions presenting risks are mostly hunters, veterinarians, and laboratory personnel.

Treatment

An antibiotic treatment can be prescribed in case of suspicion after contact with an infected animal or after tick bites. Once the diagnostic is established (confirmed by laboratory analyses), a specific curative treatment must be administered. The bacteria responsible for tularaemia could also be used for bioterrorism. They are on the list of pathogenic agents to keep a close eye on.