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Tularemia
“Rabbit Fever”
Francisella tularensis
Michelle Lawrence
Elizabeth Stolarczuk
What is Tularemia?
 One
of the most infectious pathogenic
bacteria known
 Divided into two subcategories, type A
(virulent) and type B (avirulent)
 Mortality rate as high as 30-60% without
antibiotic treatment; with, 2%
 Sores, fever, aches, chills, weight loss,
general incapacitation
The Organism
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Small, nonmotile, aerobic, gram-negative
coccobacillus
Thin lipopolysaccharide-containing envelope
Hardy, non-spore forming, survives for weeks at
low temperatures in water, moist soil, hay, straw,
decaying animal caracasses
Type A common in North America
Type B common in Europe and Asia, thought to
be causative agent of all human cases
History
 First
discovered as a plaguelike disease of
rodents in 1911
 Studied in Japan between 1932 and 1945,
and also for military purposes in the West
 WHO 1969 study on F. tularensis’s serious
ability as a biological weapon
 Largest recorded airborne tularemia
outbreak in 1966-67 in Sweden
Infection/Disease
 Can
infect humans through the skin,
mucous membranes, gastrointestinal tract,
lungs
 Major target organs are lymph nodes,
lungs, spleen, liver, kidney
 Symptoms vary with virulence of
organism, dose, and inoculation site
Viability in Biological Weaponry
The Working Group on Civilian Biodefense
concludes that a weapon using airborne
tularemia would likely result 3 to 5 days
later in an outbreak of acute,
undifferentiated febrile illness with incipient
pneumonia, pleuritis, and hilar
lymphadenopathy.
I know of no other infection of
animals communicable to man
that can be acquired from
sources so numerous and so
diverse. In short, one can but feel
that the status of tularemia, both
as a disease of nature and of
man, is one of potentiality.
– R.R. Parker
Making Tularemia a Weapon
 An
aerosol release would have the worst
medical and public consequences
 Not spread from person to person
 Slower progression of illness and lower
case-fatality rate than inhalational plague
or anthrax
 Costs to society of $5.4 billion per every
100,000 exposed persons
Treatment and Precautions
 Mass
casualty situation, oral doxycycline
and ciprofloxacin are treatments of choice,
and are contained in national stockpile
 Vaccination developed, live and
attenuated, used to protect laboratorians,
effective against the bacterium after 2
weeks
 No simple, rapid, reliable diagnostic tests
in case of mass exposure available
Sources

Tularemia. Center for Civilian Biodefense
Strategies, Johns Hopkins University. 24 October
2002. http://www.hopkinsbiodefense.org/pages/agents/agenttularemia.html
Dennis,
David T, MD, MPH. Tularemia as a
Biological Weapon. The Journal of the American
Medical Association. 24 October 2002.
http://jama.amaassn.org/issues/v285n21/ffull/jst10001.html