الجمعة، 10 يونيو 2011

Rabbit Fever - Tularemia


Overview, Causes, & Risk Factors

Tularemia is a bacterial infection that is transmitted to humans from an infected animal or insect.
What is going on in the body?
Tularemia is caused by the bacterium, Francisella tularensis. Transmission of this infection is usually from the bite of wild or domesticated animals as well as ticks, fleas, and mosquitoes that are infected with this organism. A person may also become infected just by coming in contact with an infected animal (by skinning an infected rabbit, for example) or from the bite of a blood-sucking insect.
What are the causes and risks of the disease?
The Francisella tularensis bacteria cause tularemia. A person risks exposure to this bacteria from:
  • close contact with animals and certain insects that are infected with the organism. Hunters and trappers are at risk. In the US, ticks and rabbits remain the main source of infection for humans.

  • contact with blood-sucking insects, including ticks

  • direct exposure to an infected animal, such as handling, skinning, or eating raw meat

  • water contaminated by infected animals

    • Symptoms & Signs

    What are the signs and symptoms of the disease?
    The general symptoms of tularemia may include:
  • sudden onset of fever

  • chills

  • muscle aches

  • headache

  • open sore on the skin at the site of the bite

  • swollen lymph nodes

  • conjunctivitis or infection of the eye

  • sore throat

  • respiratory symptoms, such as coughing

  • a swollen liver and spleen

    • Diagnosis & Tests

    How is the disease diagnosed?
    Tularemia is usually diagnosed with an antibody titer test that checks the person's blood for antibodies against the bacteria. After the medical history and physical examination, the healthcare provider may order tests, including:
  • chest x-ray

  • bone scan

  • biopsy of lymph nodes and sores

  • abdominal ultrasound

    • Prevention & Expectations

    What can be done to prevent the disease?
    Tularemia can be prevented by wearing gloves and masks when handling potentially infected animals, especially wild rabbits. Game meats should be thoroughly cooked prior to eating. Long pants and socks can protect a person from tick bites. The Centers for Disease Control and Prevention has a live vaccine that can be given to decrease the frequency and severity of infection. Using insect repellants and removing ticks quickly may also decrease the risk of tularemia.
    What are the long-term effects of the disease?
    When treated promptly, tularemia seldom has long-term effects. If it is untreated or if treatment is delayed, the infection may affect any part of the body, causing:
  • lung problems, such as pneumonia

  • gastrointestinal problems, such as damage to the stomach

  • damage to the cornea of the eye

  • enlargement of the heart

  • liver problems, such as hepatitis

  • bone disease or infection producing osteomyelitis

  • infection of the spinal fluid or fluid surrounding the brain, such as meningitis


    • If untreated, severe forms of tularemia can be fatal.
    What are the risks to others?
    There have been no documented cases of tularemia being spread from one person to another.

    Treatment & Monitoring

    What are the treatments for the disease?
    Early treatment of tularemia with antibiotics is vital. For severe cases, hospitalization is necessary to provide intravenous fluids, breathing treatments, and any other needed help. Surgery to drain lesions or lymph nodes may also be necessary.
    What are the side effects of the treatments?
    Side effects vary with the specific antibiotic. Antibiotics can cause stomach upset, allergic reaction, and rash. Surgery poses a risk of bleeding, infection, and allergic reaction to the anesthesia.
    What happens after treatment for the disease?
    Outcome after treatment will depend on the extent of illness. A person may recover quickly from tularemia and need no further treatment. If the infection is extensive, surgery and recovery may require more time.
    How is the disease monitored?
    A person who is diagnosed with tularemia should monitor symptoms closely. Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Danielle Zerr, MD
    Date Written:
    Editor:Wendel, Sandra J., BA
    Edit Date:10/04/00
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:04/11/01
    Sources
    Taber's cylcopedic Medical Dictionary, F.A. Davis, 1993
    Harrison's Principles of Internal Medicine, Fauci, 1998
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