Tularemia

Signs and Symptoms

Glandular tularemia appears as a local ulcer and regional swelling of the lymph nodes, fever, chills, headache and malaise. Typhoidal tularemia appears with fever, headache, malaise, discomfort in the center of the chest, prostration, weight loss and a non-productive cough.

Diagnosis

Physical findings are usually non-specific. Chest x-ray may reveal a pneumonia and swelling of the lymph nodes. Routine culture is possible but difficult. The diagnosis can be established retrospectively by serology.

Treatment

Administration of antibiotics (streptomycin or gentamicin) with early treatment is very effective.

Preventative Measures

A live, attenuated vaccine is available as an investigational new drug. It is administered once by scarification. A two-week course of tetracycline is effective as prevention when given after exposure.

Isolation and Decontamination

Standard Precautions for healthcare workers. Organisms are relatively easy to render harmless by mild heat (55 degrees Celsius for 10 minutes) and standard disinfectants.