In tularemia – colloquially known as hare plague – (thesaurus synonyms: Abdominal tularemia; Eye tularemia; Chrysops fever; Francis disease; Gastrointestinal tularemia; Generalized tularemia; Rabbit fever; Deer fly fever; Infection by Francisella tularensis; Infection by Pasteurella tularensis; Ingestion in tularemia; Conjunctivitis due to tularemia; Lemming fever; Lung tularemia; Ohara disease; Oculoglandular tularemia; Palvant valley disease; Parinaud’s disease; Francis disease; Rodent plague; Lemming fever; Pneumonia in tularemia; Pulmonary tularemia; Sepsis in tularemia; Septic tularemia; Tracheobronchitis due to Francisella tularensis; Tularemia; Typhoid tularemia; Ulceroglandular tularemia; Wild rabbit disease; ICD-10 A21. -) is an infectious disease caused by the gram-negative, coccoid (spherical), sporeless bacterium Francisella tularensis.
The disease belongs to the bacterial zoonoses (animal diseases).
Pathogen reservoirs are various small mammals such as hares, rabbits, mice, rats or squirrels.
Occurrence: The pathogen occurs throughout the northern hemisphere. In Germany the infection is very rare.
The contagiousness of the pathogen is high. The pathogen is destroyed by heat and disinfectants. It is resistant to cold.
Two biovars of the highly contagious pathogen can be distinguished:
- Francisella tularensis biovar tularensis (Jellison type A).
- Francisella tularensis biovar holarctica (Jellison type B)
Transmission of the pathogen (route of infection) occurs directly by blood-sucking parasites (ticks, mosquitoes, horseflies), through skin or mucosal contact with infectious animal material or indirectly through consumption of insufficiently heated contaminated food such as meat (hares), as well as through the ingestion of contaminated water. The pathogen can also be transmitted by inhalation of infected dust.
Human-to-human transmission: is not known, but is conceivable.
The incubation period (time from infection to onset of disease) is 1-14 days, usually 3-5 days.
Depending on the site of entry of the pathogen and the infectious dose, the following forms of tularemia may occur:
- Glandular – involvement of the lymph nodes.
- Intestinal – involvement of the gastrointestinal tract.
- Oculoglandular – involvement of the eyes and local lymph nodes.
- Oropharyngeal – Involvement of the mouth/throat and local lymph nodes.
- Pulmonary – Involvement of the lungs
- Typhoidal – typhoid-like with sepsis (blood poisoning); lethality up to 60%.
- Ulceroglandular – involvement of skin and lymph nodes.
A deliberate release of the pathogen in the sense of bioterrorism is possible.
In Germany, between 3 and 15 cases occur per year. In Europe, 20-50 diseases per year are counted.
The disease leads to a long-lasting immunity.
Course and prognosis: The disease is often lethal. Without antibiotic therapy, the lethality (mortality in relation to the total number of people infected with the disease) is over 30%. Even with treatment, the lethality rate is still around 5%.
In Germany, detection of the pathogen is reportable according to the Infection Protection Act (IfSG).
