Tularaemia - including symptoms, treatment and prevention

Tularaemia is caused by infection with a bacterium called Francisella tularensis. Tularaemia occurs in North America, Europe and Asia. A few cases have been acquired in Australia.

Tularaemia is mainly a disease of animals such as rabbits, squirrels, birds, sheep, cats and dogs.

Epidemics can occur.

Tularaemia is a notifiable condition1.

How tularaemia is spread

People may develop tularaemia by:

  • being bitten by biting or blood-sucking insects (such as some types of ticks, flies and mosquitoes)
  • having contact with infected animals
  • consuming F. tularensis contaminated food or drink
  • breathing in F. tularensis contaminated air.

F. tularensis is a potential bioterrorism agent.

Signs and symptoms of tularaemia

Thumb with skin ulcer of tularemia.The signs and symptoms depend on the site of entry of F. tularensis and other factors and may include:

  • an ulcer at the bite site with painful and swollen draining lymph glands (usually if exposed through the skin) (see image)
  • painful throat, painful and swollen lymph glands in the neck, nausea, vomiting, diarrhoea, and abdominal pain (usually if exposed through eating, drinking or oral contamination from the hands)
  • painful conjunctivitis(usually if exposed through the eye).

Other symptoms of tularaemia may include:

  • painful and swollen lymph glands in the neck
  • fever and chills
  • muscle and joint aches
  • headache
  • cough, shortness of breath, and chest pain
  • rash.

Complications can occur including meningitis (inflammation of the lining of the brain and spinal cord), septic shock and renal failure.

Diagnosis of tularaemia

Diagnosis is usually made by a series of blood tests. The bacteria may sometimes be grown from specimens such as a skin swab, sputum, or lymph gland sample.

Incubation period

(time between becoming infected and developing symptoms)

2 to 10 days

Infectious period

(time during which an infected person can infect others)

Person to person spread is rare or non-existent.

Treatment for tularaemia

Tularaemia usually responds to treatment with appropriate antibiotics.

Surgical drainage of lymph nodes may be needed.

Prevention of tularaemia

  • Exclusion from childcare, preschool, school and work is not necessary.
  • When travelling overseas to areas where tularaemia occurs:
    • Avoid being bitten by biting or blood-sucking insects by wearing appropriate clothing and applying insect repellent, following the manufacturer’s instructions. See Fight the bite for more information. 
    • Avoid contact with untreated water where infection is common in wild animals.
    • Do not drink untreated water where infection is common in wild animals.
    • Wear gloves when handling wild animals (such as rabbits).
    • Ensure any meat eaten is completely cooked.

Useful links

1 - In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.

Image - Courtesy of Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA)