• through the bite of ticks or sometimes deer flies;
• by handling infected animals such as rodents and rabbits;
• by handling the carcasses of infected animals;
• by getting the bacteria into the eyes, nose or mouth;
• by eating the undercooked meat of infected animals;
• by inhaling dust from contaminated soil or plants; and
• by drinking contaminated water.

In BC and Canada, animals most often found infected with tularemia include beavers, muskrats and hares.

Other names for tularemia include: rabbit fever, deer-fly fever, Ohara disease, and Francis disease.

Symptoms vary depending on how the person was exposed. The majority of tularemia infections present as open sore skin infections (ulcers) with swelling and tenderness of nearby lymph glands. Flu-like symptoms (fever, sore throat, cough, muscle aches) can occur with any tularemia infection. People can also develop pneumonia. Most tularemia infections are mild and can be easily treated with antibiotics. Severe forms of tularemia can be fatal if not treated appropriately. 

• ulcers on the skin or mouth
• swollen and painful lymph glands
• sudden fever
• chills
• headache
• diarrhea
• muscle aches
• dry coughs
• progressive weakness
• joint pain
• sore throat
• swollen and red eyes

Symptoms usually appear 3 to 5 days after exposure to the bacteria, but can take as long as 14 days.

Pets and tularemia 
Symptoms of tularemia in pocket pets like hamsters, gerbils, degues and chinchillas depend on the animal species. Infected rabbits often show no sign of disease. In rabbits that do develop symptoms and in rodents, the symptoms may include:

• lethargy
• reduced feeding
• weakness
• rough hair coat
• reluctance to move
• increased rate of breath
• fever
• swollen lymph glands
• ulcers
• sudden death

Animals acquire infection through tick, fly, and mosquito bites and by contact with contaminated environments. Infected animals can transmit the infection to other animals by biting, scratching or by direct exposure to infected rodent waste or nesting materials contaminated with infected rodent waste.

People can get tularemia through: 

• being bitten or scratched by an infected animal
• handling or cleaning an infected animal, its toys, cage or feeding equipment
• being bitten by an infected tick, deerfly or other insect
• breathing in air contaminated with bacteria as a result of disturbing litter, nesting materials, soil, grain or hay contaminated with rodent waste.
• eating or drinking contaminated food or water

People infected with tularemia do not spread the disease to other people or animals. 

Usually diagnosis is by identifying the clinical signs and confirming the diagnosis by a blood test.

If tularemia is diagnosed or suspected, your doctor should prescribe antibiotics, which must be taken according to the directions supplied with your prescription to ensure the best possible result. A vaccine for tularemia is not available. The disease is often mild and can resolve on its own. However, severe forms can be fatal if not recognized and treated.

Be sure to let the doctor know why you think you may have been in contact with tularemia. Ask your doctor to talk to a Medical Health Officer for further advice. 

People who think they have been exposed to tularemia should monitor themselves for symptoms for up to 14 days (2 weeks) after last exposure and see a physician if they develop symptoms (see above).

What should I do if I think my pet has Tularemia? 
Consult your veterinarian. Be sure to let the vet know why you think you your pet may have tularemia. Ask your vet to talk to a Medical Health Officer for further advice. 

If you are concerned your pet may have tularemia and your pet is sick or dies:

• Wear rubber gloves when handling it. Commercially available dishwashing gloves that have no tears are adequate.
• Remember to wash your hands thoroughly with warm water and soap after removing your gloves and after every contact with the sick animal or its environment.
• Remove nesting material in a manner that minimizes aerosolization of particles.
• Clean the cage and animal accessories in hot soapy water using any commercially available household disinfectant. Rinse the cage in a 10% bleach solution (one part household bleach, nine parts water). Let the cage air dry for at least 10 minutes and rinse again with water to counteract the corrosive action of bleach on metal cages.
• If your pet dies, double bag it and dispose of it in the garbage or bury it deep enough (1 metre) that it will not be dug up by other animals. You may also consider incinerating the body.

If you believe your pets might have been ill or died from tularemia, you should monitor yourself for symptoms for up to 14 days (2 weeks) after your last contact with your pet and see a physician if you develop any of the symptoms described above.

The bacteria Francisella tularensis occur naturally in wildlife found in many parts of Canada and the United States. To prevent infection, you should:

• Avoid tick bites while outdoors by wearing protective clothing when hiking in forested areas or when landscaping or doing lawn maintenance in areas with long grasses.
• Wash your hands, using soap and warm water:
  • After handling wild or pet animals (alive or dead)
  • After you clean an animal cage or tank
• Note any change in the behaviour of your pets (especially rodents, rabbits and hares) or livestock, and consult a veterinarian if they develop unusual symptoms.
• Always wear gloves when disposing of dead animals (wild or domestic). Animal carcasses should be incinerated when possible, or double bagged in plastic and buried more than one metre deep or put in the municipal garbage.