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Alternative names: rabbit fever, deer fly fever, Pahvant Valley plague

Type of infection: bacterial

Incubation period: 1 to 14 days, averaging 3-5 days

Mortality rate: from 1% to 50% (see below)

Vector: ticks and deer flies (rabbits are the usual carriers)


Tularemia has been known to man since at least the 14th century BC, when outbreaks likely struck the ancient Canaanites. In fact, the first known use of biological warfare was with tularemia. The Hittites used infected sheep to spread the disease to their enemies during various periods of conflict.

In more recent times, tularemia was first identified by modern medicine in 1912. There have been sporadic outbreaks in North America and Europe over the years but no major events with this disease.

Catching Tularemia

The main vector for tularemia is the tick and the deerfly, which can pass the disease to humans from carriers such as rabbits, muskrats, groundhogs, and other such animals. It is possible to inhale infected dust or other particles directly from an animal, which makes this a notable threat for hunters when skinning their catch. There have even been cases of small animals run over by lawnmowers, and the liquid and debris in the air has gotten someone ill.

It is even possible to develop tularemia from drinking water that an infected animal has been in contact with. Even so, the most common way of getting tularemia in the United States is through an insect bite.

Tularemia does not spread from one person to another, so it will not be directly contagious if someone gets sick. But if infected animals and insects are in your area, it can easily be contracted by several people in your group.

Because there are various ways to catch tularemia, the symptoms and treatment can be quite varied.

Signs & Symptoms

A large sore or ulcer will form where you first pick up the infection, if you have been bitten by a tick or a deerfly. If you eat an infected animal, there will be sores in the mouth or throat instead. With any sort of indirect inhalation, you can get some irritation in the throat, nose or eyes. The sores will be minimal in such a case. Infected people will also show loss of appetite, lethargy and fever that can reach 104F. Lymph nodes can swell, and develop further sores. In this way, it can be a similar appearance as bubonic plague.

Once the disease has progressed without treatment, there will be respiratory symptoms such as cough, chest pain, and strained breathing. The pneumatic symptoms will appear quicker and are more severe if you get ill from inhalation, as mentioned above. Left untreated, there can be organ failure that leads quickly to death.

Diagnosing tularemia can be hard because it's uncommon and the symptoms aren't that unique, especially if the person doesn't have the tell-tale ulcer sores.


Compared to many other contagions, tularemia is fairly treatable, particularly if acquired through a bug bite. Antibiotics such as streptomycin, ciprofloxacin and gentamicin are particularly known to take care of tularemia well. Such treatment will need to continue for at least 10 days, with 20 being preferable.

With antibiotics, most people will survive tularemia without any complications or lingering problems. Even without treatment, the survival rate is quite high for cases of insect bite transmission. If you have inhaled the bacteria, then the mortality rate can jump to 50% without treatment because it gets directly into the lungs.


The best way to prevent tularemia is to wear long sleeves and long pants when in the woods, particularly if you know that ticks or deerflies are common in your area. Wear insect repellant as well. If you do get a tick, remove it properly as soon as possible.

If handling wild animals, especially rabbits, wear a mask and gloves. When eating wild-caught small animals, always cook the meat thoroughly before eating. There is no publicly available vaccine for tularemia.

Risk Assessment

Tularemia is a relatively rare disease not a particularly virulent threat through natural channels. Even so, it's important to know the details about it because it is also considered a very excellent candidate for weaponization, because it is so each to catch through the skin or inhalation, and it easily controllable with antibiotics.

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