Tularemia (child care and schools)

What is tularemia?

Tularemia is an infection caused by Francisella tularensis bacteria. It can be transmitted to people through exposure to infected animals or environmental contamination. Hares, rabbits, and rodents are particularly susceptible to the disease and often die in large numbers during an outbreak.

Signs and symptoms

Tularemia illness ranges from mild to life-threatening. Symptoms depend on how the bacteria enter the body. All forms of tularemia result in a fever, which can be very high. Lymph glands usually swell. Ulcers can form at the site of exposure through skin due to fly or tick bites or direct contact. Eye exposure can result in irritation and inflammation. Oral exposure symptoms following ingestion of contaminated food or water include sore throat, mouth ulcers, and tonsillitis. Inhalation results in the most severe form of tularemia and symptoms include cough, chest pain, and difficulty breathing. Respiratory symptoms can also result from other forms of tularemia left untreated when the bacteria spreads to the lungs.

Incubation period

Usually three to five days but can be up to 14 days

Contagious period and spread

Tularemia is not known to spread person-to-person. It is spread through:

• Bites from deer flies or ticks (dog ticks and wood ticks in Colorado).
• Handling infected animals.
• Breathing dust or aerosol containing bacteria.
• Eating or drinking contaminated food or water.

Public health reporting requirements

• Tularemia infections are reportable to local or state public health within one working day.
• Report die-offs of hares, rabbits, or rodents to local public health.

Control of spread

• Tularemia occurs naturally in many parts of Colorado.
• Use insect repellents and treat clothing and gear to prevent tick and fly bites.
• Teach children to avoid touching or handling sick or dead animals. Adults should use care and wear gloves when handling sick or dead animals and avoid ticks (or fleas) that may be on the carcass looking for a new blood meal.
• Cook food thoroughly and make sure water is from a safe source.
• Check for ticks after outdoor activities and safely remove attached ticks as soon as possible.

Treatment

Tularemia is treated with antibiotic regimens that usually last from 10 to 21 days, depending on the stage of illness and medication prescribed. 

Exclusion

None

Role of teachers, caregivers, and family

• Note any change in behavior of pets or livestock. Consult a veterinarian if they develop unusual symptoms.
• Check the area for carcasses prior to mowing and safely discard them to avoid mowing over dead animals.
• Report die-offs of rabbits and rodents to public health.