• Tularemia

    (Rabbit Fever; Deer-Fly Fever)


    Tularemia is a rare bacterial infection. The effects of the infection will depend on where the exposure occurs. It can be deadly if not treated.


    Tularemia is caused by specific bacteria. It is normally found in small animals, such as mice and rabbits. The bacteria can pass to humans through:
    • Bites of infected animals, ticks, or deer flies
    • Contact with an infected animal's tissues or contaminated water, food, or soil; can enter the body through the lungs, eyes, mouth, nose, or skin
    The infection does not pass between people.

    Risk Factors

    Factors that may increase your chance of tularemia include:
    • Hunting, trapping, or butchering infected animals
    • Working with infected animals or their tissue
    • Working in a laboratory with the bacteria
    • Eating meat from an infected animal
    • Being bitten by an infected mosquito or tick
    • Biological terrorism


    Symptoms usually occur 3-5 days after exposure. The symptoms will depend on where the bacteria entered the body, the type and amount of bacteria you were exposed to, and your immune system.
    Pneumonic symptoms (lung problems):
    • Fever
    • Chills
    • Fatigue
    • Headache
    • Body aches
    • Sore throat
    • Cough
    • Burning sensation or pain in chest
    Ulceroglandular symptoms (skin and lymph gland problems):
    • Raised, red bump that continues to swell
    • Raised area opens, drains pus, and forms an ulcer
    • May form a dark scab
    • Swollen, tender lymph nodes
    • Fever
    • Chills
    Glandular symptoms (problems in lymph nodes):
    • Swollen, tender lymph nodes
    Oculoglandular symptoms (problems in eyes and lymph nodes):
    • Sensitivity to light
    • Tearing
    • Puffy eyelid
    • Swelling, redness, and sores in the eye
    • Swollen lymph nodes
    Oropharyngeal symptoms (mouth and throat problems):
    • Irritated membranes in the mouth
    • Sore throat
    • Ulcers in the throat or on tonsils
    • Swollen lymph nodes
    Intestinal symptoms:
    • Fever
    • Abdominal pain
    • Diarrhea
    • Vomiting
    Typhoidal symptoms (full body problems):
    • Fever
    • Chills
    • Headache
    • Muscle aches
    • Poor appetite
    • Nausea
    • Vomiting
    • Diarrhea
    • Abdominal pain
    • Cough
    Symptoms of progression from other types:
    • Swollen lymph nodes
    • Difficulty breathing
    • Bleeding
    • Confusion
    • Coma
    • Organ failure
    • Shock
    • Death
    Swollen Lymph Nodes
    Swollen Lymph Nodes
    Copyright © Nucleus Medical Media, Inc.


    You will be asked about your symptoms and medical history. You will be also asked about possible sources of exposure. A physical exam will also be done.
    Your body fluids may be tested. This can be done with:
    • Culture of body fluids
    • Skin test
    • Blood test
    Images may be needed. This can be done with a chest x-ray.


    Antibiotics can treat most tularemia infections. The first few doses of antibiotics will be injected in a muscle or given through a vein. You may need to take antibiotics by mouth for a few days after the initial dose. Treatment can last for 10-14 days. Make sure to take all of your medication even if you feel better.
    Tularemia infections are reported to public health officials. This will help them track any outbreaks.


    Measures to prevent the disease include:
    • Do not handle sick or dead animals.
    • Wear gloves, mask, and goggles if skinning or butchering animals.
    • Completely cook game meats.
    • Take precautions if you live in an area with ticks or deer flies:
      • Wear protective clothing.
      • Use tick repellant.
      • Check skin often for ticks.
      • Do not touch a tick with your hand.
    • Follow precautions when working in a laboratory.


    Centers for Disease Control and Prevention http://www.cdc.gov

    UPMC Center for Health Security http://www.upmchealthsecurity.org


    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca


    Tularemia. Centers for Disease Control and Prevention website. Available at: http://emergency.cdc.gov/agent/tularemia. Accessed January 22, 2015.

    Tularemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113638/Tularemia. Updated February 1, 2016. Accessed September 12, 2016.

    Tularemia. Illinois Department of Public Health website. Available at: http://www.idph.state.il.us/public/hb/hbtulare.htm. Accessed January 22, 2015.

    Revision Information

    • Reviewer: EBSCO Medical Review Board David L Horn, MD
    • Review Date: 03/2017
    • Update Date: 01/13/2014
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