Tularemia (rabbit fever, deer fly fever) is a rare contagious disease which can attack the skin, eyes, lymph nodes, lungs and sometimes other internal organs. It is caused by the bacterium Francisella tularensis and mainly affects mammals ( rodents, rabbits and hares), although it can also infect birds, reptiles and fish.

Tularemia may be spread to humans through insect bites and direct contact with an infected animal. If diagnosed early, it can be treated effectively with specific antibiotics.


There are several types of tularemia, and which type you get depends on how and where the bacteria enter the body. Usually, they enter through skin or mucous membranes, but they can also be inhaled or eaten. Each type of tularemia has its own set of symptoms.

Ulceroglandular tularemia is the most common form of the disease. The symptoms include:

  • A skin ulcer that forms at the site of infection
  • Swollen and painful lymph glands
  • Fever
  • Chills
  • Headache
  • Exhaustion

Glandular tularemia showing the same symptoms of ulceroglandular tularemia, except no skin ulcers.

Oculoglandular tularemia which affects the eyes and may cause eye pain, redness swelling  and an ulcer on the inside of the eyelid

Oropharyngeal tularemia usually caused by eating poorly cooked wild animal meat or drinking contaminated water, which affects the digestive tract. The symptoms include fever, sore throat, mouth ulcers, vomiting and diarrhea.

Pneumonic tularemia, more common in the elderly people with coughing, chest pain and difficulty in breathing.

Typhoidal tularemia, a rare and serious form of the disease which usually causes: high fever, extreme exhaustion, vomiting and diarrhea, enlarged spleen, enlarged liver and pneumonia.


Tularemia does not pass from person to person and does not occur naturally in humans. It is a worldwide phenomenon, especially in rural areas, because many mammals, birds, insects and fish are infected with F. tularensis. The organism can live for weeks in soil, water and dead animals.

Tularemia has several ways of transmission. In general, tularemia is passed on through: insect bites, exposure to sick or dead animals, airborne bacteria and contaminated food or water.

Risk Factors

Certain occupations or activities, or living in certain areas have a greater risk. The following can increase the risk of developing tularemia: hunting and trapping. gardening or landscaping and working in wildlife management or veterinary medicine.


If no medical measures are taken, tularemia can be fatal. Other possible complications include:

  • Inflammation of the lungs (pneumonia).
  • Infection around the brain and spinal cord (meningitis).
  • Irritation around the heart (pericarditis).
  • Bone infection (osteomyelitis).


There have been unsuccessful attempts to develop a tularemia vaccine. People must protect against infection with tularemia when working in a high-risk occupation or living in an area where tularemia exists with these measures:

  • Protect yourself from insects.
  • Protect the children from insects
  • Protect the pets.
  • Take care when gardening.
  • Handle animals carefully.