Tularaemia

Tularaemia, also known as rabbit fever, is an infectious disease caused by the bacterium Francisella tularensis. Both humans and animals can be affected and humans can get infected through direct or indirect contact with infected animals or through an insect bite. Tularaemia is rare in Belgium, with less than 5 cases reported each year. The disease can be cured with antibiotics.

What is tularaemia?

Tularaemia is an infectious disease affecting animals and humans. Among animals, the disease is most common in rabbits, hares and rodents, but other animals, like livestock and pets, can also get infected. The bacterium has 4 subspecies, of which F. tularensis holartica, is the one found in Europe. The disease caused by this subspecies is milder than the disease caused by F. tularensis tularensis, which is the subspecies found in North America. The other two subspecies are F. tularensis novicida and F. tularensis mediaasiatica, which rarely cause illness.

How do humans get infected with tularaemia?

Humans can get infected after a direct contact with the skin of an infected animal or with crops, soil or water contaminated with the bacterium. Tick bites are also a way of transmission. Infection through ingestion of contaminated food or water, through insect bites or through the inhalation of infected aerosol can also occur, but is less frequent. Infected individuals cannot infect the people around them.

Symptoms of tularaemia

Not all infected people will become sick. The disease will appear on average 3 to 5 days after the infection, but it can take up to three weeks. The first symptoms are usually flu-like, with fever, headache, muscle ache and throat ache. The other symptoms of the disease depend on the way the bacteria have entered the human body. The most common form of the disease is the ulceroglandular infection, which occurs after handling an infected animal. This form of tularaemia is characterised by a skin ulcer, and by swollen and painful glands. Eye infections and problems with the lungs, mouth, digestive tract, spleen and liver can occur in the other forms of the disease. Fatal cases are only recorded upon infection with F. tularensis tularensis which is not present in Europe.

Diagnosis of tularaemia

It is difficult to diagnose tularaemia based on the clinical symptoms alone, as the disease can often be mistaken for other diseases with similar symptoms. Laboratory analyses are necessary to confirm an infection with F. tularensis. Detection of antibodies against the bacterium in the blood and analyses identifying the presence of the bacteria (culture or PCR) in biopsies are used to diagnose tularaemia in the laboratory.

Treatment of tularaemia

If you are diagnosed by tularaemia by your doctor, he/she will prescribe you an antibiotic treatment.

Who is mainly at risk of getting tularaemia?

The main groups at risk of infection are hunters, farmers, veterinarians, gardeners and people spending a lot of time outdoors in the woods.

Prevention of tularaemia

Tularaemia can be prevented in the following ways:

  • Wear gloves and other protective equipment when handling animals or gardening
  • Prevent insect and tick bites by wearing protective clothing and using insect repellent
  • Cook wild meat thoroughly and make sure you use safe water supplies
  • Prevent your pets from getting infected by giving them flea and tick protection and by avoiding  contact between them and dead animals
  • Take sick pets to the veterinarian.

Sciensano hosts the National Reference Laboratory (NRL) for tularaemia, connected within a network of other European National Laboratories. Sciensano is also responsible for the surveillance of tularaemia by collecting information on the cases occurring in Belgium.

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