ExitCare ImageTularemia is a serious disease that can affect the skin, eyes, and lungs. This disease can be life-threatening if it is not treated.


Tularemia is caused by the bacteria Francisella tularensis. This bacteria can infect ticks and other insects as well as over 100 different types of animals. People can catch the disease through:

  • Tick bites.

  • Bites from other infected insects, including mosquitos, flies, and lice.

  • Handling an infected animal. In the United States, the most common animals infected with this bacteria include rabbits, beavers, muskrats, squirrels, and rodents.

  • Eating contaminated meat or drinking contaminated water.

  • Airborne spread of contaminated material, including dust, hay, and water.


Symptoms typically begin 3 to 5 days after exposure to the bacteria. However, symptoms can start as soon as 1 day after exposure or as long as 21 days after exposure. Common symptoms include:

  • Chills and fever.

  • Loss of appetite.

  • Weakness.

  • A swollen, painful lymph node or nodes.

  • Sores (ulcers) at the site of a tick bite.

If exposure to the bacteria occurred from eating or drinking contaminated food or water, a severe sore throat may occur along with swollen and painful lymph nodes in the neck. Pneumonia may occur if the bacteria is inhaled. This can lead to chest pain, a cough, and shortness of breath.


Tularemia is most commonly suspected if you have had a tick bite or if you handled a possibly infected animal and your caregiver finds an ulcer and a swollen, painful lymph node or nodes somewhere on your body. Blood tests can be done at least 2 weeks after the start of your symptoms to prove the likely presence of this infection. Your caregiver may also take a chest X-ray to look for signs of pneumonia. Your caregiver may also grow a culture from your blood or from a sample of fluid that drains from the ulcer or lymph node to look for the bacteria.


Tularemia is treated with antibiotic medicine. Antibiotics may be taken orally or given through an intravenous (IV) access tube.


Because this infection is most commonly transmitted through tick bites, it is important to avoid these bites. Ticks prefer to hide in shady, moist ground. However, they can often be found above the ground clinging to tall grass, brush, shrubs, and low tree branches. They also inhabit lawns and gardens, especially at the edges of woodlands and around old stone walls. In tick-infested areas, the best precaution against infection is to avoid contact with soil, leaf litter, and vegetation as much as possible. Campers, hikers, field workers, and others who spend time in wooded, brushy, or tall grassy areas can avoid exposure to ticks by using the following precautions:

  • Wear light-colored clothing with a tight weave to spot ticks more easily and prevent contact with the skin.

  • Wear long pants tucked into socks, long sleeve shirts tucked into pants, and enclosed shoes or boots.

  • Use insect repellent. Spray clothes with insect repellent containing either DEET or permethrin. Only DEET can be used on exposed skin. Make sure to follow the manufacturer's directions carefully.

  • Wear a hat and keep long hair pulled back.

  • Stay on cleared, well-worn trails whenever possible.

  • Check yourself and others frequently for the presence of ticks on clothes. If you find one tick, there may be more. Check thoroughly.

  • Remove clothes after leaving tick-infested areas and, if possible, wash them to eliminate any unseen ticks. Check yourself, your children, and any pets from head to toe for the presence of ticks.

  • When attached ticks are found, remove them as soon as possible. Use a tweezer to grab hold of the tick by its mouth parts and pull it off.

  • Shower and shampoo after possible exposure to ticks.


  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Take your antibiotics as directed. Finish them even if you start to feel better.


  • You have trouble breathing.

  • You have a fever.

  • You develop a severe headache or stiff neck.