Tularemia
Tularemia
Tularemia is a potentially serious illness caused by the bacterium Francisella tularensis found in animals (especially rodents and rabbits). Tularemia is sometimes referred to as deerfly fever or rabbit fever.
In 1911, G. W. McCoy discovered the disease in squirrels in Tulare County, CA. Edward Francis discovered that the deer-fly transmitted the bacteria through infected blood. Tularemia has been reported in all US states except Hawaii.
Symptoms of tularemia may include:
- sudden fever
- enlarged lymph nodes
- chills
- headaches
- possible conjunctivitis
- diarrhea
- muscle aches
- sweating
- joint pain and stiffness
- dry cough
- progressive weakness
- possible red spot on skin forming an ulcer
Additional Symptoms- People can also develop chest pain, bloody sputum and can have trouble breathing and/or may stop breathing. Other symptoms of tularemia can include ulcers on the skin or mouth, swollen and painful lymph glands, swollen and painful eyes, and a sore throat.
Complications can include meningitis, osteomyelitis, pericarditis or pneumonia. Symptoms can appear 3 days after exposure to the bacteria, but can take as long as 14 days to notice symptoms.
People can be exposed to tularemia several different ways:
- being bitten by an infected tick, deerfly or other insect
- handling infected animal carcasses
- eating or drinking contaminated food or water
- breathing in (inhaling) the bacteria
TREATMENT- People who have been exposed to the tularemia bacteria should be treated as soon as possible with antibiotics. The disease can be fatal, especially if it is not treated with the right antibiotics.
Streptomycin is the drug of choice for the treatment of tularemia. The drug is bactericidal and patients treated with streptomycin usually begin to respond within 48 hours of its administration. Relapses can occur if the drug is given too early in the course of the disease or if is not continued long enough.
Current treatment recommendations are as follows:
Adults: preferred choices are Streptomycin, 1 gm IM twice daily for 10 days or Gentamicin, 5 mg/km IM or IV once daily for 10 days.
Adults: alternative choices are Doxycycline, 100 mg IV twice daily for 14-21 days or Chloramphenicol, 15 mg/kg IV 4 times daily for 14-21 daysor Ciprofloxacin, 400 mg IV twice daily for 10 days.
Children: preferred choices are Streptomycin, 15 mg/kg IM twice daily (maximum daily dose, 2 gm) for 10 days or Gentamicin, 2.5 mg/kg IM or IV 3 times daily for 10 days.
Children: alternative choices are Doxycycline, >45 kg, give adult dosage for 14-21 days <45 kg, give 2.2 mg/kg IV twice daily for 14 - 21 days or Ciprofloxacin, 15 mg/kg IV twice daily for 10 days (maximum daily dose, 1 gm) or Chloramphenicol, 15 mg/kg IV 4 times daily for 14 - 21 days (maximum daily dose, 4 gm).
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