Topic- Tularemia
Content
1. Definition
2. Epidemiology
3. Etiology
4. Signs and symptoms
5. Pathogenesis
6. Diagnosis
7. Treatment
8. Complications
9. Refrence
What isTularemia?
Tularemia is a rare infectious disease that can
attack your skin, lungs, eyes, and lymph nodes.
Sometimes it’s called rabbit fever or deer
fly fever. It’s caused by a bacteria
called Francisella tularensis.
Epidemiology
 The majority of infections in humans and
animals are caused by F.
tularensis subspecies tularensis (the more
virulent species) and F.
tularensis subspecies holarctica. Human
disease is rarely associated with the
subspecies novicida, Francisella philomiragia,
and Francisella hispaniensis .
 In North America, F. tularensis has been described
in the United States, Canada, and Mexico. In the
United States, the majority of cases traditionally
occur in the south-central states . Over time,
however, the southern border of tularemia in the
United States has shifted northward . As an
example, the number of reported cases in
Colorado, Nebraska, South Dakota, and Wyoming
dramatically increased in 2015, and 74 percent of
cases occurred in Arkansas, Colorado, Kansas,
Missouri, Nebraska, Oklahoma, South Dakota,
andWyoming .This is consistent with the
predicted effects of climate change on the
geographic distribution of tularemia .
Etiology
 People can become sick with tularemia, but it’s not a disease that
naturally occurs in humans. It often affects rabbits and other animals
including rodents, sheep, and birds. House pets like dogs and cats can
get tularemia too.
 These are some of the ways people can get it:
 Insect bites, especially from a deer fly or tick
 Coming into contact with the skin, hair, or meat of an animal that’s
infected
 Consuming contaminated water or food, such as undercooked meat
 Breathing in bacteria that comes up from the soil during an activity
like construction or gardening
 It’s also possible to become infected if you’re exposed to the bacteria
in a laboratory setting, or potentially, in an act of bioterrorism.
Symptoms
 Ulceroglandular tularemia is the most common variety of the disease.
Symptoms can include:
 Lymph glands that are painful
 swollen
 Fever
 Chills
 Headache
 Fatigue
 Oculoglandular tularemia affects the eyes. Symptoms can include:
 Pain, swelling, or discharge in the eye
 Redness in the eye
 Light sensitivity
 An ulcer that forms inside the eyelid
 Tender lymph glands around the ear, neck, and jaw
Pathogenesis
 The cell wall of F tularensis possesses high
levels of fatty acids, and wild strains
have anelectron-transparent, lipid-rich
capsule. Loss of this capsule may result in
loss of serum resistance and virulence.
 A subcutaneous inoculum of 10 organisms is sufficient to induce
disease, whereas an inhalational exposure of 25 organisms may cause
a severely debilitating or fatal disease. Over the first 3-5 days after
cutaneous exposure, the organism multiplies locally and a papule
forms.
 Infection produces an acute inflammatory response initially involving
local macrophages, neutrophils, and fibrin.T lymphocytes, epithelioid
cells, and giant cells then migrate into local necrotic tissue.
Diagnosis
 Tularemia can be difficult to diagnose. It is a rare disease,
and the symptoms can be mistaken for other, more
common, illnesses. For this reason, it is important to share
with your health care provider any likely exposures, such as
tick and deer fly bites, or contact with sick or dead animals.
 Blood tests and cultures can help confirm the diagnosis.
Treatment
 Blood tests and cultures can help confirm the diagnosis.
Antibiotics used to treat tularemia include
 streptomycin,
 gentamicin,
 doxycycline, and ciprofloxacin.
 Treatment usually lasts 10 to 21 days depending on the
stage of illness and the medication used.
 Although symptoms may last for
several weeks, most patients
completely recover.
Complication
 Pneumonia
 Lung abscess
 Respiratory failure,
including possible
acute respiratory
distress syndrome
(ARDS)
 Rhabdomyolysis
 Renal failure with
possible hemodialysis
 Hemoptysis
 Meningitis
•Pericarditis
•Peritonitis
•Appendicitis
•Perisplenitis
•Osteomyelitis
•Guillain-Barré syndrome
•Hepatitis
•Sepsis
•Endocarditis
•Suppurative lymphadenitis
Prevention
 Optimal preventative practices include
limiting direct exposure when handling
potentially infected animals, such as
wearing gloves and face masks while
handling potentially infected animals
(importantly when skinning deceased
animals)
Tularemia

Tularemia

  • 1.
  • 2.
    Content 1. Definition 2. Epidemiology 3.Etiology 4. Signs and symptoms 5. Pathogenesis 6. Diagnosis 7. Treatment 8. Complications 9. Refrence
  • 3.
    What isTularemia? Tularemia isa rare infectious disease that can attack your skin, lungs, eyes, and lymph nodes. Sometimes it’s called rabbit fever or deer fly fever. It’s caused by a bacteria called Francisella tularensis.
  • 4.
    Epidemiology  The majorityof infections in humans and animals are caused by F. tularensis subspecies tularensis (the more virulent species) and F. tularensis subspecies holarctica. Human disease is rarely associated with the subspecies novicida, Francisella philomiragia, and Francisella hispaniensis .
  • 5.
     In NorthAmerica, F. tularensis has been described in the United States, Canada, and Mexico. In the United States, the majority of cases traditionally occur in the south-central states . Over time, however, the southern border of tularemia in the United States has shifted northward . As an example, the number of reported cases in Colorado, Nebraska, South Dakota, and Wyoming dramatically increased in 2015, and 74 percent of cases occurred in Arkansas, Colorado, Kansas, Missouri, Nebraska, Oklahoma, South Dakota, andWyoming .This is consistent with the predicted effects of climate change on the geographic distribution of tularemia .
  • 6.
    Etiology  People canbecome sick with tularemia, but it’s not a disease that naturally occurs in humans. It often affects rabbits and other animals including rodents, sheep, and birds. House pets like dogs and cats can get tularemia too.  These are some of the ways people can get it:  Insect bites, especially from a deer fly or tick  Coming into contact with the skin, hair, or meat of an animal that’s infected  Consuming contaminated water or food, such as undercooked meat  Breathing in bacteria that comes up from the soil during an activity like construction or gardening  It’s also possible to become infected if you’re exposed to the bacteria in a laboratory setting, or potentially, in an act of bioterrorism.
  • 7.
    Symptoms  Ulceroglandular tularemiais the most common variety of the disease. Symptoms can include:  Lymph glands that are painful  swollen  Fever  Chills  Headache  Fatigue  Oculoglandular tularemia affects the eyes. Symptoms can include:  Pain, swelling, or discharge in the eye  Redness in the eye  Light sensitivity  An ulcer that forms inside the eyelid  Tender lymph glands around the ear, neck, and jaw
  • 8.
    Pathogenesis  The cellwall of F tularensis possesses high levels of fatty acids, and wild strains have anelectron-transparent, lipid-rich capsule. Loss of this capsule may result in loss of serum resistance and virulence.  A subcutaneous inoculum of 10 organisms is sufficient to induce disease, whereas an inhalational exposure of 25 organisms may cause a severely debilitating or fatal disease. Over the first 3-5 days after cutaneous exposure, the organism multiplies locally and a papule forms.  Infection produces an acute inflammatory response initially involving local macrophages, neutrophils, and fibrin.T lymphocytes, epithelioid cells, and giant cells then migrate into local necrotic tissue.
  • 9.
    Diagnosis  Tularemia canbe difficult to diagnose. It is a rare disease, and the symptoms can be mistaken for other, more common, illnesses. For this reason, it is important to share with your health care provider any likely exposures, such as tick and deer fly bites, or contact with sick or dead animals.  Blood tests and cultures can help confirm the diagnosis.
  • 10.
    Treatment  Blood testsand cultures can help confirm the diagnosis. Antibiotics used to treat tularemia include  streptomycin,  gentamicin,  doxycycline, and ciprofloxacin.  Treatment usually lasts 10 to 21 days depending on the stage of illness and the medication used.  Although symptoms may last for several weeks, most patients completely recover.
  • 11.
    Complication  Pneumonia  Lungabscess  Respiratory failure, including possible acute respiratory distress syndrome (ARDS)  Rhabdomyolysis  Renal failure with possible hemodialysis  Hemoptysis  Meningitis •Pericarditis •Peritonitis •Appendicitis •Perisplenitis •Osteomyelitis •Guillain-Barré syndrome •Hepatitis •Sepsis •Endocarditis •Suppurative lymphadenitis
  • 12.
    Prevention  Optimal preventativepractices include limiting direct exposure when handling potentially infected animals, such as wearing gloves and face masks while handling potentially infected animals (importantly when skinning deceased animals)