Pathogenesis (disease development) The Gram-negative bacterium Francisella tularensis is then transmitted to humans by ticks and horseflies or by contact with infected meat, etc. (see below) transmitted directly to humans. Transmission from person to person is not possible. The incubation period is usually three to five days. Etiology (causes) Behavioral causes Contact with infected animal … Tularemia (Rabbit Plague): Causes
General measures Observance of the general hygiene measures! In the occurrence of fever: Bed rest and physical rest (even if fever is only mild; if limb pain and lassitude occur without fever, bed rest and physical rest is also required, as pericarditis/pericarditis could occur as a result of the infection). Fever below 38.5 °C does … Tularemia (Rabbit Plague): Therapy
The following symptoms and complaints may indicate tularemia (rabbit plague): Fever Malaise Myalgia (muscle pain) Abdominal discomfort (abdominal pain) Nausea (nausea)/vomiting Diarrhea (diarrhea) Cough Dyspnea (shortness of breath) Skin ulcers (skin ulcers) Lymphadenopathy (lymph node enlargement) Conjunctivitis (conjunctivitis) Stomatitis (inflammation of the oral mucosa) Pharyngitis (pharyngitis) Tonsillitis (tonsillitis) Sepsis (blood poisoning)
Medical history (history of illness) represents an important component in the diagnosis of tularemia (hare fever). Family history What is the general health status of your relatives? Social history What is your profession? Do you work a lot with wildlife? Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? Do you … Tularemia (Rabbit Plague): Medical History
Infectious and parasitic diseases (A00-B99). Bartonella henselae (cat scratch disease). Brucellosis – infectious disease caused by different types of the genus Brucella. Infectious mononucleosis (synonyms: Pfeiffer glandular fever, infectious mononucleosis, mononucleosis infectiosa) – acute febrile illness caused by the Epstein-Barr virus. Influenza (flu) Legionnaires’ disease (legionellosis) Anthrax (anthrax) Mycobacterioses Plague Q fever (Coxiella burnetii) Syphilis … Tularemia (Rabbit Plague): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by tularemia (hare plague): Respiratory system (J00-J99) ARDS (Acute Respiratory Distress Syndrome) – acute respiratory failure in the setting of multiorgan disease. Pneumonia (pneumonia) Eyes and eye appendages (H00-H59). Dacryocystitis (lacrimation) associated with oculoglandular tularemia. Blood, hematopoietic organs – immune system … Tularemia (Rabbit Plague): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin [skin ulcers/skin ulcers), mucous membranes, pharynx [stomatitis/mucositis; tonsillitis/tonsillitis]. Eyes [conjunctivitis/conjunctivitis] including sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? … Tularemia (Rabbit Plague): Examination
1st order laboratory parameters – obligatory laboratory tests. Diagnostics of the pathogen should be performed in specialized laboratories (highly infectious!). Direct pathogen detection is difficult Serologically by antibody detection (AK against Francisella tularensis). Antigen detection (ELISA; Enzyme Linked Immunosorbent Assay), nucleic acid detection (PCR; Polymerase Chain Reaction). Direct or indirect detection of Francisella tularensis must … Tularemia (Rabbit Plague): Test and Diagnosis
Therapeutic targets Elimination of the pathogens Avoidance of complications Therapy recommendations Symptomatic therapy (analgesics/pain relievers, antiemetics/anti-nausea and anti-nausea medications, if necessary). Antibiosis (antibiotic therapy: aminoglycosides or doxycycline (tetracyclines). See also under “Further therapy“.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – representation of the heart current … Tularemia (Rabbit Plague): Diagnostic Tests
To prevent tularemia, attention must be paid to reducing risk factors. Behavioral risk factors Contact with infected animal material (via skin/mucous membranes) [esp. hunters]. Consumption of infected food Drinking infected drinking water Consumption of insufficiently heated contaminated meat (e.g., hare). Inhalation of infected/contaminated dust or aerosols (e.g., during industrial washing and chopping of contaminated vegetables, … Tularemia (Rabbit Plague): Prevention
