What is Tularaemia?
Tularaemia is caused by the Francisella tularensis bacteria. The disease can affect both animals and humans. Human infection is uncommon but can be serious if not diagnosed and treated promptly. There are several subtypes of F. tularensis; Type A strains, found mainly in North America, are generally associated with more severe disease, while Type B strains occur across Europe and Asia and tend to cause milder illness.
The organism is found mainly in the Northern Hemisphere, particularly in the United States, Canada, Sweden, Finland, Norway, Turkey, Russia, Japan, and parts of Central and Eastern Europe, where it circulates in wildlife such as rabbits, hares, rodents, and other small mammals. Outdoor activities such as hiking, hunting, farming, or camping can increase exposure to animals with Francisella tularensis.
People become infected when the bacteria enter the body through the skin, eyes, mouth, or lungs. This can occur through insect bites, handling infected animals, drinking contaminated water, eating undercooked meat, or inhaling contaminated dust or aerosolised particles. Importantly, person-to-person transmission has not been documented.
FAQs
Which countries have tularaemia?
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Tularaemia occurs across parts of North America, Europe, and Asia, with the highest numbers of cases reported from countries such as the United States, Canada, Sweden, Finland, Norway, Russia, Turkey, Japan, and several countries in Central and Eastern Europe.
The disease is usually associated with wildlife and rural environments, particularly areas where rabbits, hares, rodents, ticks, and biting flies are common. Australian travellers are most likely to encounter tularaemia when visiting these regions for outdoor activities such as hiking, camping, hunting, fishing, or farming. Australia has recorded only a small number of locally acquired cases.
Can tularaemia spread between people?
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No. Tularaemia is not known to spread from person to person. Infection occurs through contact with infected animals, bites from infected ticks or flies, contaminated food or water, or inhalation of contaminated dust or aerosols. Travellers do not need to isolate from someone diagnosed with tularaemia, although appropriate medical treatment is important.
Is there a vaccine for travellers?
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There is no routinely available vaccine for Australian travellers. Prevention relies on avoiding insect bites, wearing protective clothing, using insect repellent, avoiding contact with sick or dead animals, drinking safe water, and ensuring meat is thoroughly cooked. A travel doctor can provide advice if travelling to an area where tularaemia is known to occur, particularly for high-risk outdoor activities.
What should I do if I develop a fever, swollen lymph nodes, a skin ulcer, or a persistent cough after travel?
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Seek medical attention promptly if you develop symptoms of tularaemia during travel or within three weeks of returning home. Symptoms can include fever, chills, severe fatigue, swollen lymph nodes, a skin ulcer at the site of an insect bite or animal exposure, sore throat, red or painful eyes, cough, chest pain, or difficulty breathing. Symptoms usually appear within a few days of exposure but can take up to three weeks to develop.
Tell your doctor where you travelled and whether you had contact with wildlife, tick or insect bites, untreated water, or outdoor activities such as camping, hunting, or farming. Tularaemia is rare in Australia, so a travel history can be an important clue to diagnosis. Early antibiotic treatment is highly effective and helps prevent serious complications.
What to Know
Symptoms of Tularaemia
Symptoms of tularaemia usually develop three to five days after exposure, although they can appear anywhere from 1 to 21 days later. The illness often begins suddenly with fever, chills, severe tiredness, headache, muscle aches, and a general feeling of being unwell.
The specific symptoms depend on how the bacteria entered the body. If infection occurs through the skin, such as after a tick bite or contact with an infected animal, a painful skin ulcer may develop at the site of exposure, often accompanied by swollen and tender lymph nodes nearby.
If contaminated food or water is the source, symptoms may include sore throat, abdominal pain, nausea, vomiting, or diarrhoea. When the bacteria are inhaled, tularaemia can cause a chest infection with cough, chest pain, and difficulty breathing. Eye exposure can result in redness, pain, swelling, and sensitivity to light.
Without treatment, the infection can occasionally spread to other parts of the body and lead to complications such as pneumonia, bloodstream infection (sepsis), or organ failure. Serious illness is uncommon when appropriate treatment is started promptly.
Diagnosis and treatment of Tularaemia
Tularaemia can be challenging to diagnose because its symptoms resemble many other infections, including influenza, glandular fever, pneumonia, and some tick-borne diseases. For travellers, a recent history of hiking, camping, hunting, fishing, wildlife contact, insect bites, or exposure to untreated water can provide important clues.
Diagnosis can be made by growing the bacteria in the lab. Samples may be sent from ulcers, lymph nodes, or respiratory secretions. Because the bacterium is highly infectious in the laboratory environment, clinicians and laboratories need to be informed when tularaemia is suspected. The diagnosis can also be made through blood tests that look for antibodies to Francisella tularensis. Testing by PCR is also available in a small number of specialised laboratories internationally.
Travellers who develop fever, swollen lymph nodes, unusual skin ulcers, or respiratory symptoms during travel or after returning to Australia should seek medical attention promptly and tell their doctor where they have travelled and what activities they undertook. Tularaemia generally responds well to antibiotics when diagnosed early, and most people recover completely with appropriate treatment, although severe infections may require hospital admission.
Prevention of Tularaemia
There is no routinely available tularaemia vaccine for Australian travellers, so prevention focuses on avoiding exposure to the bacteria.
When travelling in countries where tularaemia occurs, insect bite prevention is important. Wearing long sleeves and trousers, using insect repellents containing DEET or picaridin, and checking for ticks after outdoor activities can reduce the risk of infection from insect vectors. Travellers spending time in forests, grasslands, or rural environments should be particularly careful.
Follow food and water precautions such as drinking treated or bottled water and ensure meat is thoroughly cooked before consumption. Avoid holding carcasses or engaging in activities that generate dust in farming areas to minimise exposure to airborne bacteria. Anyone involved in hunting, trapping, wildlife research or animal handling should wear gloves and follow good hygiene practices.
Tularaemia is a very rare infection among Australian travellers. However, those undertaking outdoor, rural, or wildlife-related activities in parts of North America, Europe, or Asia can minimise their risk through careful insect protection, food and water hygiene, and avoidance of direct contact with wild animals.