Tularemia
The good news is, most kinds of infectious disease are less likely when one spends time in the woods. The best place to get germs, after all, is from other humans. There are a few new ones to keep an eye out for though. Since many prepper’s plans have them moving out of troubled populated areas, you might want to put tularemia on your watch list.
Tularemia is a bacterial disease, caused by a germ called Francisella tularensis. It’s also a zoonotic disease, meaning we get it from other species, not other humans. (Other animals such as cats and dogs can catch it the same way we do.) . In the U.S., the main source of human infection are rabbits and the ticks that feed on rabbits. In fact, tularemia is sometimes called ‘rabbit fever’. In Canada, Europe, Russia and nearby areas, there’s a different strain more likely to be carried by rodents (including beavers, voles, and house mice).
Rabbits and their ticks are the main carriers of the U.S. version of tularemia.
Good news first or bad news first about tularemia?
Are you a fan of good news first, or bad news first? The bad news is, the fatality rate without antibiotic treatment is 30-60% for the U.S. variety (far less for the rodent-carried sort; so if you’re going to get it, get it from a beaver). The other bad news is, it’s a potential bioterror agent, because it makes a stable, highly infective aerosol. In fact, it’s believed that both the U.S. and the Soviets had ‘weaponized’ tularemia during the Cold War.
The good news is that natural infections are not very common in the U.S. This germ is thought to kill pretty much 100% of the natural carriers (such as rabbits) that get it, limiting its transmission.
If you do run into an infected animal, it’s a very easy germ to catch. We think most infections come by being bitten by a tick that came off of an infected rabbit. There have been a good number of cases that apparently came from cleaning a rabbit that was in the early stages of infection. If you see white spots on the liver and spleen of a rabbit you’re cleaning, I’d say it’s not worth the risk to handle that thing any more (but don’t feed it to the dog, either!) . There were even a couple of kids on the East Coast who got the respiratory form after driving over the carcass of an infected rabbit with their lawn mower and inhaling some residue. (Ewww!)
Infection
So how do you know if you have it? One infectious disease expert thinks any unexplained fever after having been out in rabbit country is worth consideration as a case of tularemia. (To be fair, experts tend to see their specialty everywhere. I once had a cardiologist tell me he considered every pain within five feet of the heart to be a heart attack until proven innocent.)
By signs and symptoms, it’s hard to know tularemia is the source. Like many other diseases, it first presents with fever, chills, aches, etc. The fever climbs higher; and cough and respiratory pain develop often even if the exposure was through the skin, not the lungs. Weakness and wt loss are common. There may be nausea, vomiting, and diarrhea.
If the germ came through the skin (tick bite or scratch that got rabbit blood in it), the local lymph nodes get very enlarged and tender a few days after the fever starts. For a hand wound, that would look like tender lumps in the armpit. This might be a good time to start the antibiotics (or so the WHO says; I myself am not a doctor so don’t give medical advice). If the antibiotics are given now, complete resolution is likely. If not, the lymph node abscesses may need to be drained of pus before the infection can be cleared. I for one would not like to have to try that!
Ulcer
An ulcer might form at the site of the broken skin where the germ got in. If it does, that’s a good indicator that the fever is from tularemia.
These ulcers don’t always show up at the area where the germ entered, but when they do, it’s a good clue that the fever may be from tularemia.
The respiratory version, caused by inhaling bacteria-laden debris (or a bioterror attack) comes on with with high fever, cough, chest pain, sore throat, profound weakness, drowsiness, and profuse sweating. One odd feature is that the pulse doesn’t go up as the fever does, so that can help with diagnosis. (Most people with fevers get high pulse rates, and the higher the fever the higher the pulse. Not so with tularemia.)
When people get tularemia, it’s treated with antibiotics. The favored approach is 10-14 days of ciproflaxin, with 400-500 g doses given twice a day. An alternative is doxycycline, 100 mg twice a day for at least 15 days.
Protecting yourself (and your pets) from tick bites is a great protection, not only from tularemia but several other nasty infections. Special care when cleaning rabbits might be in order. Their bones are prone to making jagged things during cleaning, if my memory serves, so watch the stabs and mind where the blood goes.
The following video shows other, less serious, dangers that can come from rabbits.
I got much of this information from Tarnvic, A. (ed.) 2007. WHO Guidelines on Tulaeremia. WHO Epidemic and Pandemic Response.
I did read through some other sources to see all were in agreement, and they pretty much were.
Good work Spice, Thank you for the organized way you presented the details.
It’s knowledge like this that’ll see us through, safe and sound.
Thank you! I hope so.
When I was a kid my grandparents told me never to kill and eat rabbit until after a hard freeze. And be sure to cook it thoroughly. Now I know that the hard freeze probably killed off the ticks. Thanks for a timely article.