Hazard Recognition

Tularemia, also known as "rabbit fever" or "deer fly fever," is caused by the Francisella tularensis bacterium. As few as 10 of these organisms can cause the disease. Humans become infected through a variety of environmental exposures. Exposure may lead to a severe and sometimes fatal illness. The following references aid in recognizing disease characteristics and hazards associated with tularemia.

Disease Recognition

• Tularemia. Centers for Disease Control and Prevention (CDC). Offers fact sheets and overviews, information about infection control, laboratory testing, and surveillance and investigations.
  • Frequently Asked Questions (FAQ) About Tularemia. Provides answers about disease transmission, occurrence, symptoms, diagnosis and terrorist use.
• Tularemia Outbreak in Prairie Dogs in Texas. Centers for Disease Control and Prevention (CDC), (August 6, 2002). Covers the investigation by officials from the CDC and the Texas Department of Health of an outbreak of tularemia in wild prairie dogs at a commercial facility in Texas that distributes the animals in the United States and other countries.
• Tularemia - United States, 1990-2000. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) 51(09):182-4, (March 8, 2002). Covers reported cases of tularemia occurring in the United States from 1990-2000. Also provides background information on tularemia including symptoms and diagnosis.
• Tularemia. Center for Infectious Disease Research and Policy (CIDRAP). Provides links the latest news and information available about tularemia.
  • Tularemia: Current, comprehensive information on pathogenesis, microbiology, epidemiology, diagnosis, treatment, and prophylaxis. Provides an overview of tularemia and includes agent information, clinical symptoms, pathogenesis, microbiology, and epidemiology.
• Tularemia. MedlinePlus Health Information. Includes illustrations, definitions, disease causes, incidence, and risk factors.
• Hornick, R. "Tularemia Revisited." New England Journal of Medicine 345(November 29, 2001): 1637-1639. Covers basic information about tularemia and presents a review of recent outbreaks in the United States.
• Current Description of Tularemia. University of California Los Angeles (UCLA), Department of Epidemiology, School of Public Health. Provides a description of tularemia, including its occurrence and mode of transmission.

Bioterrorist Threat Evaluation

On September 11, 2001, following the terrorist incidents in New York City and Washington, DC, the Centers for Disease Control and Prevention (CDC) recommended heightened surveillance for any unusual disease occurrence or increased numbers of illnesses that might be associated with intentional release of a biological agent. Tularemia, in aerosol form, is considered a possible bioterrorism agent. Although it is not easy to disseminate, it takes only a small amount of inhaled bacterium to cause infection. The following references provide information about evaluating the threat of tularemia as a biological weapon.

• "Abstract: "Consensus Statement: Tularemia as a Biological Weapon"." Abstracted from Dennis, D., et al. Journal of the American Medical Association (JAMA) 285.21(June 6, 2001): 2763-2773. Contains information about the history of tularemia and its use in biological warfare, as well as its epidemiology, microbiology, pathogenesis, diagnosis, vaccination, and treatment. Also discusses infection control and decontamination procedures. Links to full text version.