Tularemia is an infectious disease caused by the bacterium Francisella tularensis. This bacterium is resistant to cold climates and is not destroyed by substances such as bleach.. However, it is quite sensitive to many common household disinfectants.
The pathology is considered an anthropozoonosis, i.e. a infection that circulates among animals but can eventually be transmitted to humans. The species that serve as a reservoir for the bacteria are small mammals.
We could name mice and squirrels, as well as hares and rabbits, as animals that serve as repositories for bacteria. Its worldwide distribution is from the Northern Hemisphere: Europe, Asia and North America.
The disease has been known among doctors since 1911. It was in California that an outbreak was described that led to the identification of the bacterium. Today, a hundred years later, considered a disease capable of being used as a biological weaponHence the legal obligation to notify the authorities when a confirmed case appears.
Tularemia facts
Tularemia has two preferential ages in which it appears: among children aged five to nine years and among the elderly over seventy-five years. It prevails in two periods of the year: summer in the northern hemisphere – from May to August – and winter – from November to February..
Due to its form of contagion, there are some people with certain professions or habits who are more exposed, including:
- Gardeners: are exposed to inhalation of the bacteria.
- vets: due to direct contact with animals.
- hunters: hunters are exposed to animal carcasses and ingestion if they eat them.
Routes of transmission of tularemia
Tularemia is transmitted from animals to humans and between animals, but never between humans. A sick person cannot infect a healthy person. Therefore, there is no need to isolate patients.
Now, among the ways of transmission from animals to humans we can describe:
- Physical contact: It is the most frequent form of infection. Humans come into direct contact with the body of an animal infected with tularemia. In general, transmission occurs through the existence of wounds and exposure of the mucous membranes. The most exposed are the inhabitants of rural areas, hunters, veterinarians and farmers. It can be contact with live animals or corpses.
- Bites: arthropods have been identified that also serve as carriers of the disease. Ticks and horseflies, for example. Even for a decade transmissions were certified from animals not previously considered, such as shrimp.
- Contaminated water: It is a minor form of contagion, but not negligible. In the United States, it is estimated that up to ten percent of infections occur through drinking water contaminated with bacteria.
- Inhalation: In the suspended dust that accumulates after agricultural activities, bacteria can remain floating. The human being inhales this dust and the disease attacks the respiratory system.
symptoms of the disease
The incubation period is short; this is the time between contact with the bacteria and the onset of symptoms. Usually, three to five days is the delay. In some people it can take up to fourteen days for the first symptom to appear.
According to the place of entry of the microorganism is the clinical picture and can manifest itself with the following varieties:
- Ulceroglandular: It is the most common form of presentation. It happens when the infection has occurred by physical contact through the skin, so an ulcer forms at the site of infection. This is followed by fever, swollen glands, tiredness and headache.
- Glandular: It is a variant of the ulceroglandular form, only without the entry point ulcer on the skin.
- Eye: this clinical picture is characterized by symptoms related to the eye. The infected person has eye pain, discharge on the eyelids, eye redness, and swelling of the soft tissue near the eyelid area.
- oropharyngeal: It is a gastrointestinal manifestation of tularemia. It is usually present when the route of infection has been ingestion of contaminated meat or water. Patients suffer from fever, sore throat, vomiting, diarrhea and ulcers are located inside the mouth.
- Pulmonary: It’s actually pneumonia caused by the tularemia bacterium, so the symptoms are cough, fever, chest pain, and shortness of breath.
- Typhus: It is the least frequent manifestation, but perhaps the most serious. Organs such as the spleen and liver are enlarged, the fever is very high, and the digestive system is affected by vomiting and diarrhea.
Treatment of tularemia
Tularemia has one effective treatment and it is antibiotics. It’s a serious disease, but detected over time can be completely cured with the correct administration of these drugs.
Antibiotic treatment can be oral or with intramuscular or intravenous injections. The drugs of choice are streptomycin and gentamicin. When the oral route is preferred, doxycycline is usually prescribed. The doctor will decide, based on the clinical picture and the characteristics of the patient, which one is appropriate.
Along with the antibiotic, corresponding supportive measures are provided for each symptom. Antifebrile, antiemetic and analgesics can be administered. Hospitalization is an option if there is dangerous organ failure.
It is assumed that once a person is infected with tularemia, they become immune to the bacteria for the rest of their life. That means you couldn’t get it again. However, Science has recorded recurrences, so preventive measures continue to be mandatory for those who have suffered from it..
So if you’ve been in environments where rodents are present, you’ve found yourself hunting or performing work related to veterinary and livestock, and after a few days you start with a fever, consult a professional to get examined.
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