Tularemia is a highly contagious infection that is very rare in Germany and can be transmitted to humans through mammals. Due to the plague-like course and the predominant occurrence in wild rabbits and hares, one also speaks of rabbit plague.
What is tularemia?
Tularemia is caused by the bacterium Francisella tularensis, so it is a bacterial infection. Since the disease can be transmitted from small mammals to humans, it is referred to as a zoonosis. For introduction to rabbit hunger, please visit sciencedict.com.
In Germany, the disease is only very rarely represented, the predominant occurrence is in north-eastern Europe, Asia and North America. Depending on the entry point of the pathogen, different manifestations of tularemia occur. The clinical picture can vary depending on the entry point of the pathogen, some examples are:
Ulceroglandular tularemia: Ulceration at the site of entry and sudden fever
Glandular tularemia: swelling of the lymph nodes
Abdominal tularemia: typhoid-like clinical picture, swelling of the spleen and liver, diarrhea and abdominal pain (abdominal organs are affected)
Intestinal tularemia: abdominal pain and diarrhea, vomiting and nausea
Causes
The cause of tularemia is a bacterial infection with Francisella tularensis. Ticks, fleas and lice can serve as reservoirs for the bacterium, and it is able to survive in frozen rabbit meat for up to three years.
The parasites that carry the pathogen can transmit the bacterium to both humans and mammals through a bite. Another route of infection with tularemia is through contact with infected mammals. This contact can take the form of bites or scratches from infected animals. It is also possible to ingest the pathogen through direct contact with excrement or blood from infected animals.
In order to become infected with tularemia, however, direct contact is not necessary; the tularemia pathogen can also be ingested through the air or contaminated water.
Symptoms, Ailments & Signs
Rabbit fever causes different symptoms in animals and humans. The eponymous rodents usually develop septicemia a few days after infection, which spreads throughout the body. The affected animals show fever, an increased respiratory rate and enlarged lymph nodes as well as an enlarged spleen as typical side effects.
In addition, the animals appear severely weakened. The rodents usually die of blood poisoning about two weeks after infection . Infected dogs do not usually die from rabbit fever, but they can develop distemper-like symptoms after infection. In humans, an infection with the bacterium Francisella tularensis is usually accompanied by symptoms that are similar to a flu infection.
The patients initially suffer from fever and headaches. These symptoms are often accompanied by nausea and vomiting. Many people also experience swelling of the lymph nodes where the bacterium entered the body. If the infection is not recognized and treated with antibiotics, it can become a life-threatening condition.
This is often announced by severe chills and abdominal pain. Many patients also experience severe sore throat. Rabbit fever in humans is not associated with symptoms specific to this disease, which is why it can only be diagnosed with certainty by blood analysis.
Diagnosis & History
The diagnosis of tularemia can often not be made unequivocally and sometimes even not at all, since the course of the disease is sometimes similar to that of a flu infection.
However, the common symptoms, such as skin ulceration and swelling of the lymph nodes, suggest tularemia. However, a direct diagnosis is only possible by means of animal experiments. For this purpose, a blood sample is taken and injected into a test animal. If the pathogen is present, this can be proven by the antibody formation of the test animal, but it should be noted here that due to the similarity between the tularemia pathogen and the thymus pathogen, an incorrect diagnosis can be made.
In humans, the incubation period is 1-10 days, after which the typical symptoms appear. If tularemia is detected early and treated appropriately with antibiotics, there are hardly any complications, but if the disease is left untreated, it leads to death in 30% of all cases. However, once the disease has been overcome, there is lifelong immunity to the tularemia pathogen.
Complications
In the absence of or inadequate treatment, tularemia can cause various symptoms that can lead to serious complications. Typical of rabbit fever is the conspicuous swelling of the lymph nodes at the site of infection, which is occasionally associated with fever and a general feeling of illness. If the course is severe, the fever rises to over 40 degrees Celsius and causes cardiovascular problems, dehydration and other complications.
Some patients also experience abdominal pain and migraines, both associated with severe discomfort and a decrease in quality of life. The characteristic sore throat can spread and possibly cause inflammation of the paranasal sinuses or even pneumonia. Rabbit fever also promotes the development of ulcers on the skin, which can also become inflamed or cause bleeding and scarring.
Drug treatment using antibiotics such as doxyclin or gentamicin is sometimes associated with side effects and interactions. Gastrointestinal complaints are particularly problematic because they correlate with the symptoms of tularemia and can therefore cause severe pain and fever. Long-term use of the corresponding preparations can severely damage the internal organs, especially the liver, kidneys and heart.
When should you go to the doctor?
In the case of tularemia, the person affected is dependent on medical examination and treatment in any case, since self-healing cannot occur in this case. The earlier the disease is detected, the better the further course is in most cases. In the worst case, tularemia can even lead to the death of the person affected, so that a doctor should be contacted as soon as the first symptoms and signs of the disease appear. A doctor should be consulted for tularemia if the affected person suffers from an increased respiratory rate and if the patient’s spleen is significantly enlarged.
Furthermore, the symptoms of an ordinary flu can also point to this disease. Most patients suffer from severe abdominal pain and also inflammation of the throat or pharynx. If the symptoms of the flu do not go away after a few days, you should definitely see a doctor. In the case of tularemia, either a general practitioner or a hospital can be consulted.
Treatment & Therapy
Tularemia is treated with an antibiotic, which can be doxyclin, ciprofloxacin or gentamicin, with streptomycin having the greatest success. Sulfonamides and penicillin should be avoided, since the pathogen is resistant to them. The antibiotic of choice should be taken for 10-17 days to ensure relapse and complete recovery from tularemia.
Prevention
There is already a vaccine against tularemia, but it is not available on the German market. However, it is also possible to prevent tularemia by following simple rules of conduct.
When coming into contact with wild animals, you should always wear disposable gloves and avoid handling suspicious animals altogether. Dust-tight breathing masks should also be worn when processing wild animals, including skinning and gutting. Veterinarians, forest workers and hunters represent special risk groups.
Aftercare
For tularemia (rabbit fever), the extent of follow-up care is determined by the type of pathogen and the severity of the disease. Pathogens of tularemia can essentially be of the subtype “F. tularensis” and the subtype “holarctica”. The subtype “F. tularensis” is distributed in North America. In 30 to 60 percent of all untreated cases of illness, the pathogen leads to the death of the patient.
In the event of death, aftercare focuses on coping with the bereavement. Psychological counseling or care is recommended by a doctor for first-degree relatives. The subtype “holarctica” occurs almost exclusively in Europe. The probability of dying from tularemia caused by the subtype “holarctica” tends to zero.
The therapy of tularemia is carried out both in the subtype “F. tularensis” as well as the subtype “holarctica” always started clinically with medication (ciprofloxacin as monotherapy). After the clinical stay, the drug therapy is continued for about 14 days during follow-up care. In order to check the success of the therapy, blood analyzes are also planned in the follow-up care.
Spontaneous healing often occurs in the “holarctica” subtype. In the subtype “F. tularensis”, on the other hand, a severe course of the disease is to be expected on a regular basis. Secondary symptoms such as endocarditis, severe septicemia, pneumonia and liver and kidney failure can occur here. In addition to continuing the drug therapy, the aftercare also focuses on treating the symptoms.
You can do that yourself
Tularemia is treated with antibiotics such as streptomycin or gentamicin. The medication must be taken strictly according to the doctor’s instructions. In addition, early initiation of therapy is important to avoid a severe course of the disease.
Medical treatment can be supported by bed rest and an appropriate diet. The weakened body needs sufficient liquid and nutrients, especially in the acute phase of the disease. Later, bland food should be eaten so as not to further burden the irritated gastrointestinal tract. Because the condition can lead to conjunctival problems, you must not drive a car. Operating heavy machinery is also prohibited. In the case of external inflammation or ulcers, care products from the pharmacy can help. In consultation with the doctor, ointments made from natural substances can be tried.
Pregnant women who have been diagnosed with rabbit fever must contact a specialist clinic. Since the use of strong antibiotics in pregnancy is not permitted, alternative treatment methods must be chosen.
In principle, rest and rest apply to rabbit fever, in conjunction with following the doctor’s instructions. Those affected can exchange information with other sufferers in internet forums or in a specialist center. The support of the partner or another reference person is also important.
