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Tularemia Reference – Symptoms, Diagnosis, Treatments
Diseases & Treatments Section @ BillDoll.com – The Billion Dollar Site
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Tularemia Reference – Symptoms, Diagnoses, Treatments
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Tularemia-From Wikipedia, the free encyclopedia
Tularemia Classification & external resources ICD-10 A21 ICD-9 021 DiseasesDB 13454 eMedicine med/2326 emerg/591 ped/2327 Tularemia (also known as "rabbit fever") is an infectious disease caused by the bacterium Francisella tularensis. The disease is endemic in North America, and parts of Europe and Asia. The primary vectors are ticks and deer flies, but the disease can also be spread through other arthropods. Rodents, rabbits, hares and ticks often serve as reservoir hosts. The disease is named after Tulare County, California.
In the United States, although records show that tularemia was never particularly common, incidence rates have further dropped to below 0.1 per 100,000, meaning the disease is extremely rare in the US today.[1]
Contents 1 Mechanism of infection 2 Incubation period 3 Treatment 4 Biological Warfare 5 External links 6 References
Mechanism of infection Francisella tularensis is one of the most infective bacteria known; fewer than ten organisms can cause disease leading to severe illness. Humans are most often infected by tick bite or through handling an infected animal. Ingesting infected water, soil, or food can also cause infection. Tularemia can be acquired by inhalation; hunters are at a higher risk for this disease because of the potential of inhaling the bacteria during the skinning process. Tularemia is not spread directly from person to person.
Francisella tularensis is an intracellular bacterium, meaning that it is able to live as a parasite within host cells. It primarily infects macrophages, a type of white blood cell. It is thus able to evade the immune system. The course of disease involves spread of the organism to multiple organ systems, including the lungs, liver, spleen, and lymphatic system. The course of disease is similar regardless of the route of exposure. Mortality in untreated (pre-antibiotic-era) patients has been as high as 50% in the pneumoniac and typhoidal forms of the disease, which however account for less than 10% of cases.[2] Overall mortality was 7% for untreated cases, and the disease responds well to antibiotics with a fatality rate of about 2%. The exact cause of death is unclear, but it is thought be a combination of multiple organ system failures.
Incubation period A patient with tularemia will most often develop flu-like symptoms between 1-14 days after infection (most likely 3-5 days.) If the patient was infected through an insect or tick bite, an eschar may develop at the bite site.
Treatment The drug of choice is Streptomycin. Tularemia can also be treated with gentamicin, tetracycline or fluoroquinolone antibiotics.
Practical research into using Tularemia as a bioweapon took place at Camp Detrick in the 1950s. It was viewed as an attractive agent because:
it is easy to aerosolize it is highly infective; fewer than 10 bacteria are required to infect it is non-persistent and easy to decontaminate (unlike anthrax) it is highly incapacitating to infected persons it has low-lethality, which is useful where enemy soldiers are in proximity to non-combatants, eg civilians The Centers for Disease Control and Prevention regard F. tularensis as a viable bioweapons agent for use by terrorists.
No vaccine is available to the general public.[3] The best way to prevent tularemia infection is to wear rubber gloves when handling or skinning rodents (or rabbits, rabbits are not rodents), avoid ingesting uncooked wild game and untreated water sources, and wearing long-sleeved clothes and using an insect repellant to prevent tick bites.
In summer 2000, an outbreak of tularemia in Martha's Vineyard resulted in one fatality, and brought the interest of the CDC as a potential investigative ground for aerosolized Francisella tularensis. Over the following summers, Martha's Vineyard was identified as the only place in the world where documented cases of tularemia resulted from lawn mowing. The research may prove valuable in preventing bioterrorism.
In 2004, three researchers at Boston University Medical Center were accidentally infected with F. tularensis, after apparently failing to follow safety procedures.[4]
In 2005, small amounts of F. tularensis were detected in the Mall area of Washington, DC the morning after an anti-war demonstration on Sept. 24, 2005. Biohazard sensors were triggered at six locations surrounding the Mall. To this date, no cases of tularemia infection have been reported as a result.[5]
In 2007, a lab of Boston University's Center for Advanced Biomedical Research, where F. tularensis were being kept for research, was evacuated after smoke set off alarms. An investigation has later determined that an electrical problem was the culprit, and no bacterial contamination was found.
Biological Warfare By the late 1950's the US biological warfare program was focused mostly on tularemia as a biological agent. The Schu S4 strain was standardized as Agent UL for use in the M143 bursting spherical bomblet. It was a lethal biological with an anticipated fatality rate of 40 - 60 percent. The rate-of-action was around three days, with a duration-of-action of 1 to 3 weeks (treated) and 2 - 3 months (untreated) with frequent relapses. UL was streptamycin resistant. The aerobiological stability of UL was a major concern, being sensitive to sun light, and losing virulence over time after release.
The United States later changed the military symbol for UL to TT (wet-type) and ZZ (dry-type) in an effort to retain security on the identity of military biologicals. When the 425 strain was standardized as agent JT (an incapacitant rather than lethal agent), the Schu S4 strain's symbol was changed again to SR.
References ^ http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5109a1.htm ^ http://www.cidrap.umn.edu/cidrap/content/bt/tularemia/biofacts/tularemiafactsheet.html#_Overview_1 ^ http://www.niaid.nih.gov/factsheets/tularemia.htm ^ http://www.boston.com/news/local/articles/2005/03/29/city_tells_bu_to_bolster_safety_of_its_medical_labs/ ^ http://www.washingtonpost.com/wp-dyn/content/article/2005/10/01/AR2005100101209.html Tularemia, NIAID Fact Sheet, April 2005. Retrieved on 2007 January 7. Retrieved from "http://en.wikipedia.org/wiki/Tularemia" Categories: Bacterial diseases | Zoonoses | Biological weapons
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