TULAREMIA, HUMAN – USA: (ALASKA), REQUEST FOR INFORMATION

In Mississippi, my Dad used to check rabbits for tularemia for Fish & Game. Rabbits were a subsistence food for many, then.
"F. tularensis was discovered in 1911 during an outburst of rabbit fever, when the disease killed a large number of ground squirrels in the area of Tulare Lake in California. Scientists determined that tularemia could be dangerous to humans; a human being may catch the infection after contacting an infected animal. The ailment soon became frequent with hunters, cooks and agricultural workers"
http://en.wikipedia.org/wiki/Tularemia

Date: Mon, 10 Aug 2009 17:18:44 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu>
Subject: PRO/AH/EDR> Tularemia, human – USA: (AK), RFI

TULAREMIA, HUMAN – USA: (ALASKA), REQUEST FOR INFORMATION
*********************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 6 Aug 2009
Source: Associated Press [edited]
http://www.ktuu.com/Global/story.asp?S=10861604

Two residents of Fairbanks, Alaska have been diagnosed with tularemia, a potentially fatal bacterial infection more commonly found in animals. Alaska Department of Fish and Game veterinarian Kimberlee Beckmen learned of the outbreak from state public health authorities late last week.

The disease can be transmitted to humans from snowshoe hares, and the hare population has been high in the interior. It’s unclear how the Fairbanks residents contracted it.

Beckmen says people are usually infected through the skin by handling sick hares, but they can also get it when bitten by ticks, flies, or mosquitoes that fed on sick hares.

A Fish and Game spokeswoman says the Fairbanks patients were treated with antibiotics and are doing well.

- — communicated by: ProMED-mail rapporteur Brent Barrett

[Tularemia is typically found in animals, especially small mammals such as voles, mice, rodents, rabbits, and hares. _Francisella tularensis_ is found in a wide range of animal hosts and is capable of surviving for weeks at low temperatures in water, moist soil, or decaying plant and animal matter. Although hundreds of differing vertebrates and invertebrates can be infected with the tularemia bacillus, no more than a dozen or so are important in its ecology. Humans become infected through a variety of mechanisms including bites of infected arthropods (mosquitoes, ticks, deerflies), handling infected or dead animals, ingesting contaminated food or water, and inhaling aerosols of bacteria. The type of exposure will dictate the form of the disease manifestation with cutaneous exposures usually resulting in the glandular or ulceroglandular forms. The type of disease in these Alaskan cases is not stated.

ProMED-mail posted an alert (20041008.2760, see below) in October 2004 regarding hamsters from a Canadian pet distributor that were found to be infected with type B tularemia as well. No human cases were reported.

Tularemia in humans is generally a rural disease and occurs naturally throughout much of North America and Eurasia. The type B strain (_F. tularensis_ biogroup palearctica) is the dominant strain in Eurasia, whereas both biogroups (type A is biogroup tularensis) are found in the USA. Type A is said to be more virulent than type B.

Although not generally transferable from person to person, the infectious dose of _F. tularensis_ is quite low, and the organism is listed among the category A bioterrorism agents.

According to statistics from the Centers for Disease Control and Prevention, during the period 2000-2006, a total of 873 cases of human tularemia were reported in the USA. In the same period, there were a total of only 3 cases reported in Alaska, with annual reports of no more than one per year, although the disease is likely underreported. See http://www.cdc.gov/tularemia/Surveillance/Tul_CasesbyState.html for the full table of number of cases reported each year by state, 2000-2006. The largest numbers were from the south-central part of the USA, with Missouri (172), Arkansas (123), and Oklahoma (79) leading the list. – Mod.LL]

[see also:
Tularemia, feline – USA (UT): alert, RFI 20090802.2719
Plague, tularemia, prairie dogs – USA (SD) 20090712.2494
Tularemia, feline, canine – USA (SD) 20090711.2481
Tularemia, rabbits – USA (02): (NM) 20090417.1458
Tularemia, rabbits – USA (NM) 20090415.1429
2008
– —
Tularemia, human, feline – USA: (NV) 20080825.2652
Tularemia, pneumonic – USA: (NYC) 20080612.1863
2007
– —
Tularemia – USA (UT, NJ) (05): UT 20070809.2590
Tularemia – USA (UT, NJ) 20070716.2283
Tularemia, lagomorphs – USA (NM) 20070622.2013
Tularemia, feline – USA (SD) 20070614.1938
Tularemia, feline – USA (CO) 20070524.1658
Tularemia, ovine – USA (ID) 20070428.1391
2006
– —
Tularemia, humans, rabbits – USA (WY) 20061101.3122
Tularemia, pneumonic – USA (MA) 20060731.2115
Tularemia, rabbits – USA (TX) 20060601.1531
Tularemia – USA (TX) (03) 20060224.0607
Tularemia, rodents, humans – USA (TX) (02): background 20060222.0577
Tularemia – USA (TX) 20060216.0508
Tularemia – USA (NE) 20060103.0024
2004
– —
Tularemia, pneumonic – USA (NYC)(04) 20041115.3081
Tularemia, pneumonic – USA (NYC) 20041110.3033
1998
– —
Tularemia – USA (New York City) (03) 19980804.1490
Tularemia – USA (New York City): RFI 19980724.1405]

………………ll/msp/sh

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