Tularemia: Are you aware of this dangerous fever transmitted by animals?

Have you suddenly developed a high fever and developed small, painful bumps on your body? Perhaps you recently went for a walk in the woods, worked on a farm, or handled an animal? Then this is a condition you may not have heard of, but you should definitely know about. It is called tularemia in medical terms. Although it is a relatively rare disease, it can be serious, so it is important to be aware of it.

Simply put, what is Tularemia?

Tularemia is an infection caused by a bacterium called Francisella tularensis . This is a disease that can be transmitted from animals to humans, which is called a zoonotic disease. This bacterium usually lives in the bodies of animals such as rabbits, squirrels, and rats. It can also be transmitted by insects such as ticks and fleas that live on the bodies of these animals.

This disease can affect different parts of the body depending on how it is transmitted. This bacterium can cause various symptoms, mainly painful swelling of the lymph nodes, and various diseases of the lungs, eyes, throat, and digestive system. In some countries, it is also called "rabbit fever".

Who is most at risk of developing this disease?

Although anyone can get tularemia, your risk of exposure to the bacteria that causes this disease may be higher depending on your occupation, hobbies, or lifestyle. The following people are at slightly higher risk:

• People who hunt or handle raw meat: This bacteria can be transmitted through contact with the meat or body fluids of hunted animals.
• Veterinarians and animal handlers: They are also at risk because they work with animals all the time.
• People who work in environments where insects bite: Farmers and those who work in forests are at higher risk of being bitten by insects such as ticks.
• People with weakened immune systems: People with HIV , cancer patients, or those taking immunosuppressant medications can easily develop these types of infections.
• Farm workers and sheep shearers: These workers are at higher risk because they work closely with animals and the environment they live in.
• Laboratory workers: Those who conduct research on this bacteria are also at risk of exposure.

What happens when this bacteria enters the body?

Imagine that this bacterium called `F. tularensis` enters your body. Our body's defenses, the cells of the immune system, try to capture and "engulf" this foreign bacterium. Normally, the bacteria would be destroyed inside those cells.

But this bacteria is very cunning. Instead of hiding inside those immune cells, they start to divide and multiply rapidly. Eventually, the immune cells are destroyed, and the swarm of bacteria that comes out invades other cells in the body. This destruction of cells and the activation of the immune system in response to it is what causes our symptoms.

What are the types and symptoms of tularemia?

Tularemia can be divided into several main types, depending on how the bacteria enter the body and where the symptoms occur. To understand this clearly, let's look at this table.

How is this disease transmitted? Is it transmitted from person to person?

There are several main ways in which tularemia is transmitted:

• Insect bites: From bites from infected ticks, mosquitoes, and other flies.
• Contact with infected animals: Through a bite or scratch from an infected animal. Also, tissues or body fluids from an infected animal can enter the body through a cut or wound in our skin.
• Infected food or water: By drinking water contaminated with bacteria or eating undercooked meat (especially game).
• Inhaling bacteria: This is a bit surprising to hear. Imagine if you use a lawnmower or other machine where there is a dead animal that has this bacteria, the bacteria can get into the air along with the tiny dust particles that are thrown up, and even inhaling it can cause illness.

No, tularemia is not transmitted directly from one person to another. This means that the disease cannot be transmitted by touching or talking to an infected person. However, it is a highly infectious disease. This means that even a very small amount of bacteria entering the body is enough to cause the disease.

How does the doctor diagnose this disease?

When you go to see your doctor, he will first ask you about your symptoms. He will also ask about your recent activities. For example:

• Have you been for a walk in the woods recently?
• Did you eat an animal like a tick?
• Are animals (especially rabbits and rats) touched?
• Did you drink unclean water?

Then, the body is examined, looking for swollen lymph nodes, skin lesions, changes in the throat or eyes, and several tests may be done to confirm the diagnosis.

• Blood tests: A blood sample is taken to check for antibodies that the body has made against the bacteria. Sometimes these may not be detected at first, so you may need to have another test a few weeks later.
• Biopsy: Taking a small piece of tissue from a skin lesion or swollen lymph node for examination.
• Other samples: Throat or nasal secretions, and fluid testing if there is fluid around the lungs.

What are the treatments for this? Can it be cured?

Yes, this is a disease that can be completely cured with antibiotics. The most important thing is to start treatment as soon as possible. Sometimes, based on the symptoms and the information you provide, the doctor may decide to start treatment before the test results are available. This is to prevent the disease from becoming serious.

Treatment usually involves taking antibiotics for 10 to 21 days. The most commonly used medications are:

• Streptomycin
• Gentamicin
• Doxycycline ( Doxycycline )
• Ciprofloxacin

Won't this get better without treatment? What are the complications?

Although some people may recover from the disease without treatment, it is very dangerous . If left untreated, especially if you are infected with the type A bacteria, the mortality rate can be as high as 30%. It can also lead to serious complications.

• Severe lung damage (Acute respiratory distress syndrome - ARDS)
• Infection of the brain or brain coverings (Meningitis)
• Heart infection (pericarditis)
• Bone infections (Osteomyelitis)
• Liver and kidney failure

Therefore, if you have symptoms, seeking immediate medical advice can be life-saving.

How can we protect ourselves from this dangerous disease?

The best thing to do is to avoid this disease. There are a few simple steps we can follow to do that.

• Insect protection: If you are going to a forest or grassy area, wear clothing that covers your body completely. Use bug spray. After coming back from the outdoors, check your body for ticks, especially your head and armpits.
• Pet Care: Consult your veterinarian about the treatments your pets need to protect themselves from ticks.
• Handle animals with care: Do not touch wild animals (living or dead) with bare hands. Wear gloves. Wash your hands thoroughly with soap after handling animals.
• Food and water safety: Cook meats, such as game, thoroughly before eating. Do not drink water directly from untreated rivers or streams.
• Environmental protection: Avoid mowing or mowing near dead animals. If you must do so, it is wise to wear a face mask to avoid inhaling dust.

When should you see a doctor?

When to see a doctor in general:

• If you have symptoms of tularemia (fever, swelling, skin lesions).
• If you suspect you have been exposed to this bacteria, your doctor may prescribe antibiotics to prevent the disease from developing.
• If symptoms recur during or after treatment.

When to go to a hospital's Emergency Treatment Unit (ETU) immediately:

If you have any of the following serious symptoms, do not waste time and go to the ETU of the nearest hospital.

• If the fever is higher than 39.4 Celsius (103 Fahrenheit).
• Dementia or mental confusion.
• Bleeding with vomiting or stool.
• Coughing up blood.
• Severe difficulty breathing.
• Blue discoloration of the skin, lips, or fingernails.
• Severe stomach pain.

Tularemia, animal-borne diseases, bacterial infections, rabbit fever, swollen lymph nodes, tick-borne diseases