Tularemia is a bacterial infection that can cause fever, chills, swollen lymph nodes, and skin sores, and the early symptoms of tularemia can look like the flu at first. People usually get tularemia after a tick or deer fly bite, contact with infected animals, or less often by breathing in contaminated dust or eating contaminated food or water. Tularemia can affect children and adults, and symptoms often begin within 3 to 5 days after exposure, though it can take up to 14 days. Not everyone will have the same experience. With prompt antibiotic treatment, most people recover well, but severe tularemia can be life threatening if it is not treated.
How many people live with Tularemia?
Worldwide, no single reliable estimate is routinely published for how many people are living with tularemia at one time, because it is usually a short-term infection and is tracked as new cases rather than long-term prevalence. In the United States, there is also no standard “people living with tularemia” count, but the CDC reports that about 200 to 300 cases are reported each year, including 216 cases in 2022 (CDC, 2024).
Overview
TularemiaSymptoms
Tularemia often starts suddenly with fever, chills, headache, and marked tiredness. Many people also develop a skin ulcer and swollen, painful lymph nodes, especially after a tick bite or animal contact. Early symptoms of tularemia can vary by how the infection enters the body.
Outlook and prognosis
With prompt antibiotics, most people with tularemia recover fully. Swollen glands or tiredness can linger for weeks, especially after more severe illness. Serious complications are uncommon when treatment starts early, but delayed care can make recovery harder.
Causes and risk factors
Tularemia is caused by infection with Francisella tularensis bacteria. Risk rises with tick or deer fly bites, handling infected rabbits or rodents, and contact with contaminated water, soil, or animal tissue. Outdoor work, hunting, and landscaping can increase exposure.
Genetic influences
For tularemia, genetics are usually not the main factor. Getting infected depends much more on exposure, though small genetic differences in immune response may affect how severely some people with tularemia become ill.
Diagnosis
Tularemia is diagnosed using your symptoms, exam, and possible exposure, such as tick bites or handling wild animals. Blood tests can help confirm the diagnosis of tularemia. Doctors may also test lymph node fluid, sputum, or a skin sample.
Treatment and drugs
Tularemia is usually treated with antibiotics, most often gentamicin, streptomycin, doxycycline, or ciprofloxacin. People with tularemia may also need fluids, pain relief, or wound care. Early treatment of tularemia usually works very well.
Symptoms
Tularemia often starts suddenly, and the first changes can feel a lot like a bad flu. The early symptoms of Tularemia often include fever, chills, tiredness, headache, and body aches. Depending on how the germ entered the body, some people also develop a skin sore, swollen glands, eye irritation, throat pain, or a cough. Symptoms vary from person to person and can change over time.
Fever is one of the most common symptoms of Tularemia and can come on quickly. Many people also feel chills, sweating, and a general sense of being very unwell.
Low energy, headache, and muscle aches are common, especially in the first few days. Day to day, it can feel like even simple tasks take more effort than usual.
Lymph nodes, often called glands, may become swollen and tender, especially near the area where the infection entered. This can happen in the neck, armpit, or groin and may make movement or touch uncomfortable.
Some people develop a painful skin ulcer at the spot of a bite or other exposure. The area may start as a small bump, then open into a sore while nearby glands swell.
How people usually first notice Tularemia?
Tularemia often first shows up suddenly, with people feeling as if they have been hit by a fast-moving flu: fever, chills, headache, body aches, and marked tiredness are common early warning signs. How tularemia is first noticed can also depend on how the bacteria entered the body, so some people develop a painful skin sore and swollen nearby lymph nodes after a tick bite or animal contact, while others first notice a sore throat, belly pain, cough, or chest pain. Because these early symptoms can look like many other infections, the clue is often the combination of abrupt fever plus a recent tick bite, handling wild animals, lawn or brush work, or possible exposure to contaminated food or water.
Types of Tularemia
Tularemia can look quite different from one person to another, depending on how the bacteria entered the body and which areas are most affected. In practice, the main types of tularemia are grouped by the pattern of symptoms they cause. Symptoms don’t always look the same for everyone. This helps explain why one person may develop a skin sore and swollen lymph nodes, while another may mainly have eye, throat, or breathing symptoms.
Ulceroglandular
This is the most common type of tularemia and often starts with a skin sore where the bacteria entered the body. Nearby lymph nodes usually become swollen and painful, and fever, chills, and tiredness are common. Many people get this form after a tick or deer fly bite, or after handling an infected animal.
Glandular
This type causes swollen, tender lymph nodes and general illness such as fever and body aches, but there is no obvious skin sore. It can resemble ulceroglandular tularemia except that the entry spot on the skin is not seen. Because the sore is missing, it may be less obvious at first what is causing the illness.
Oculoglandular
This form happens when the bacteria get into the eye, often leading to a red, painful, irritated eye. Swelling of lymph nodes near the ear, jaw, or neck is common, and some may find bright light uncomfortable. It can feel at first like a bad eye infection, but the swollen glands can be an important clue.
Oropharyngeal
This type affects the mouth and throat, usually after swallowing contaminated food or water. People with tularemia in this form may have a sore throat, mouth ulcers, trouble swallowing, swollen neck glands, and fever. In some cases, the early symptoms of tularemia mainly seem like a severe throat infection.
Pneumonic
This type mainly affects the lungs and can cause cough, chest pain, shortness of breath, and fever. It may happen after breathing in the bacteria or when another form of tularemia spreads to the lungs. This is one of the more serious types of tularemia and usually needs prompt medical care.
Typhoidal
This less common form causes a more general, whole-body illness without the clear local signs seen in other types. High fever, marked weakness, headache, stomach symptoms, and sometimes confusion can occur, and swollen lymph nodes may be absent. Because symptoms are widespread rather than focused in one area, it can be harder to recognize early.
Can I slow down the onset of symptoms?
No. There is no good evidence that lifestyle changes or home treatments can meaningfully delay the start of tularemia symptoms once the infection is in your body. The main steps that can help are prevention steps that lower the chance of getting infected in the first place, such as avoiding tick and deer fly bites, using safe food and water, and wearing protection when handling wild animals; these may reduce risk, but they do not guarantee prevention or slow symptoms after infection has already happened. If you think you were exposed, getting medical care quickly is the most useful step because early antibiotics can treat tularemia, and in some high-risk exposures doctors may use preventive antibiotics, so early action is worthwhile even though it cannot promise a certain result.
What genetics can tell you about symptoms
For tularemia, genetics usually tells doctors more about the strain of the bacteria than about your own genes: different types of Francisella tularensis can be linked to different patterns of illness, from swollen lymph nodes and skin ulcers to more serious lung infection or widespread disease. Some strains are known to cause more severe symptoms and may lead to illness that starts and worsens faster, while milder strains are more often linked to less aggressive disease. At this point, a person’s inherited genes are not used in routine care to predict exactly which symptoms they will have or when those symptoms will begin.
Causes and risk factors
People usually get tularemia after a tick or deer fly bite, contact with infected rabbits or rodents, or breathing in contaminated dust during outdoor work. Drinking contaminated water, eating undercooked wild game, and lab exposure can also cause tularemia. Common risk factors for tularemia include hunting, farming, landscaping, and spending time in rural areas where the bacteria are present. Some risks are modifiable (things you can change), others are non-modifiable (things you can’t). There are no clear inherited genetic risk factors for tularemia, but age, a weakened immune system, and daily activities can affect how likely you are to get sick after exposure.
What are the most common causes or risk factors?
Tularemia is caused by a bacterial infection, most often picked up from tick or deer fly bites, handling infected wild animals such as rabbits or rodents, or breathing in contaminated dust while mowing, farming, or landscaping. Risk is also higher from drinking contaminated water, eating undercooked wild game, or working in places where the germ is handled, such as a lab. It is not usually linked to genes or family history; the main risk comes from outdoor, animal, and work exposures, especially in rural areas where tularemia is more common.
Environmental and biological risk factors
Tularemia is an infection people usually pick up from the environment rather than from other people. The main risk factors for tularemia are linked to infected animals, biting insects, and contaminated water or dust. Doctors often group risks into internal (biological) and external (environmental). In tularemia, body entry points such as broken skin or the eyes can matter just as much as where the exposure happens.
Tick bites and, in some regions, deer fly bites are among the most common ways tularemia spreads to people. Risk is higher in places where these insects feed on infected wild animals and are common in grass, brush, or wooded areas.
Tularemia risk rises with contact with infected rabbits, hares, rodents, or animal carcasses. The bacteria can enter through the skin, especially if blood or tissue touches small cuts or scrapes.
In some settings, dried animal material or contaminated soil can become airborne as dust. Breathing in these particles can lead to tularemia, even without a bite or direct animal contact.
Swallowing bacteria in untreated water or contaminated food can sometimes spread the infection. This is more likely in areas where wildlife can contaminate natural water sources or animal products.
Genetic risk factors
Tularemia is usually not passed down through families, and it is not considered an inherited disorder. At this time, there are no well-established genetic causes of Tularemia or common inherited changes that clearly raise the chance of getting it. Rare inherited immune system conditions may affect how the body handles infections in general, but they do not explain most cases of Tularemia.
No known inheritance: Tularemia is not known to be caused by a gene change passed from parent to child. For most people, family history does not play a meaningful role in Tularemia risk.
Rare immune disorders: A small number of inherited immune problems can make some infections harder for the body to control. Even so, these conditions are not recognized as common or specific genetic risk factors for Tularemia.
Genetic testing: There is no routine genetic test used to predict who will get Tularemia. If you are wondering whether Tularemia is hereditary, the answer is usually no.
Lifestyle risk factors
Tularemia is an infection, so the main lifestyle-related risks come from behaviors that increase contact with the bacteria rather than from diet or exercise. In practice, how lifestyle affects tularemia is mostly about hunting, animal handling, outdoor habits, and food or water safety. These habits do not guarantee infection, but they can raise the chance of exposure and illness.
Hunting, skinning, or dressing rabbits and other wild animals can increase contact with infected blood or tissues. Risk is higher when cuts on the hands are uncovered or when carcasses are handled without gloves.
Frequent hiking, camping, landscaping, or brush clearing can raise the chance of tick or deer fly bites that spread tularemia. Wearing less protective clothing and skipping insect repellent can make exposure more likely.
Touching sick or dead wild animals as part of recreation, homesteading, or informal rescue can increase tularemia risk. Infection can occur through broken skin, the eyes, or the mouth after contaminated hand-to-face contact.
Eating undercooked wild game can expose a person to the bacteria that cause tularemia. Careless kitchen handling of raw game meat can also spread contamination to hands, surfaces, or other foods.
Risk prevention
Tularemia is usually prevented by avoiding the ways the bacteria reach people in daily life, such as tick bites, contact with infected animals, contaminated landscaping dust, or untreated water. Many living or working in rural areas may be at higher risk, especially during warmer months or when handling wild animals. Prevention can mean both medical steps, like vaccines, and lifestyle steps, like exercise. In this case, there is no routine public vaccine, so reducing exposure is the main way to lower the chance of tularemia.
Use an insect repellent on exposed skin and wear long sleeves, long pants, and closed shoes in brushy or grassy areas. Checking your body, clothes, children, and pets after being outdoors can lower the risk of tularemia from tick or deer fly bites.
Do not touch sick or dead wild animals with bare hands, and use gloves if you must handle them. Hunters, trappers, and people cleaning game should wash hands well and avoid splashing fluids into the eyes, nose, or mouth.
Wild rabbit and other game meat should be cooked all the way through before eating. This helps prevent infection from contaminated meat and lowers the chance of early symptoms of tularemia after a meal or food preparation.
When mowing, brush cutting, or using a leaf blower in areas where wild animals live, consider a mask and eye protection if dust is heavy. Wetting down very dusty areas first can reduce the chance of breathing in contaminated particles.
Can you prevent Tularemia?
You cannot prevent every case of tularemia, but you can lower the risk. The most reliable steps are to avoid tick and deer fly bites, use gloves if you handle wild rabbits or other wild animals, drink safe water, and cook wild game thoroughly. There is no routine vaccine for the public, so prevention mainly depends on avoiding infected animals, bug bites, and contaminated food or water.
Transmission
Tularemia is an infection people usually get from tick or deer fly bites, from touching infected animals such as rabbits or rodents, or from breathing in contaminated dust during outdoor work like mowing, farming, or landscaping. Less often, tularemia can come from drinking contaminated water or eating undercooked wild game.
If you are wondering how tularemia spreads, the key point is that it is not known to spread from person to person through casual contact, coughing, or sharing a home. Even so, tularemia is considered highly infectious because a very small number of germs can cause illness after the right kind of exposure, so prompt medical care matters after a possible exposure.
When to test your genes
For tularemia, genetic testing is not part of routine early detection or treatment planning. If you develop fever, an ulcer, swollen lymph nodes, or pneumonia after a tick or deer fly bite, handling wild animals, or possible lab exposure, doctors use infection testing, not gene testing, to guide care.
Diagnosis
Tularemia is usually diagnosed by putting together your symptoms, possible exposure, and a few targeted tests. The first clues often come from everyday details, such as a tick bite, handling wild animals, mowing over dead animals, or drinking untreated water before fever and swollen glands begin. Doctors usually begin with a careful history and exam, because the diagnosis of tularemia can look like several more common infections.
A doctor will ask about recent tick or deer fly bites, contact with rabbits or other wild animals, outdoor work, and any risky food or water exposures. They will also look for patterns such as fever, a skin ulcer, swollen lymph nodes, eye irritation, sore throat, or cough that can point toward tularemia.
Blood tests may show signs of infection and inflammation, but they do not confirm tularemia on their own. They are mainly used to support the diagnosis and to help rule out other causes of similar symptoms.
The most common confirmatory test checks for antibodies your immune system makes against the bacteria that cause tularemia. Early in illness this test can be negative, so a second sample taken later may be needed to show a rising level.
In some cases, samples from blood, a swollen lymph node, an ulcer, sputum, or other body fluids can be tested directly with specialized lab methods such as PCR or culture. These tests can help confirm tularemia, but culture must be handled with special safety precautions because the bacteria can spread in the lab.
How is Tularemia diagnosed?
Tularemia is usually diagnosed by putting together the pattern of symptoms, the doctor’s exam, and possible exposure, such as a tick or deer fly bite, contact with wild animals, or contaminated food or water. To confirm it, doctors usually order lab tests on blood or on a sample from a skin sore, swollen gland, or the lungs, looking either for signs that the body is reacting to the infection or for the germ itself; some labs may also use a test that looks for the germ’s genetic material. Because tularemia can look like other infections, it may take more than one test, and results can depend on how long the illness has been present.
Stages of Tularemia
Tularemia does not have defined progression stages. That is because it is usually described by how the infection shows up in the body and how severe it is, rather than by a steady, step-by-step decline over time. Doctors usually start with a conversation about symptoms, possible exposure to ticks or wild animals, and when the early symptoms of tularemia began. Diagnosis is usually based on symptoms, an exam, and lab tests such as blood tests or samples from the affected area, with follow-up focused on how well treatment is working.
Outlook and prognosis
With prompt diagnosis and appropriate antibiotics, the outlook for tularemia is generally very good, and most people recover fully. Prognosis depends on the form of infection, how quickly treatment starts, and whether severe complications such as pneumonia, sepsis, meningitis, or multi-organ failure develop. Ulceroglandular and glandular tularemia usually have the best outcomes, while typhoidal and pneumonic disease carry a higher risk of severe illness and hospitalization. Before effective treatment, mortality was much higher; today, deaths are uncommon overall but can still occur, especially in untreated severe cases. Reported mortality is typically low with modern care, but it is highest in typhoidal and pneumonic tularemia and in people who are older, immunocompromised, or critically ill. Some patients may have prolonged fatigue or enlarged lymph nodes for weeks to months after the infection, even after the bacteria have been cleared.
Long-term effects
Most people with tularemia recover fully with prompt treatment, but recovery can be slow, especially after a severe infection. Some may find that tiredness, weakness, or a reduced ability to get back to normal routines can last for weeks or even months. Long-term effects vary widely, and they are more likely after delayed treatment, pneumonia, bloodstream infection, or infection that spread through the body. In medical terms, these are sometimes called late effects or chronic symptoms.
Ongoing tiredness and low stamina are among the most common longer-term effects after tularemia. For many, this can mean feeling worn out after a normal workday or needing more time to recover after activity.
Enlarged or tender lymph nodes can take a long time to settle, especially in gland-related forms of tularemia. In some people, the area may stay uncomfortable or drain for weeks before fully healing.
When tularemia affects the lungs, cough, chest discomfort, or shortness of breath may continue during recovery. These long-term effects of tularemia are more likely after pneumonia or a more severe illness.
If tularemia caused a skin sore or ulcer, healing can be slow and may leave a scar. Some people are left with lingering tenderness or changes in skin texture around the affected area.
How is it to live with Tularemia?
Tularemia can make everyday life feel abruptly smaller for a while, because the illness often brings high fever, deep fatigue, swollen lymph nodes, and sometimes a painful skin sore, cough, or eye irritation depending on how the infection entered the body. For many people, that means needing real rest, time away from work or school, and help with basic routines until antibiotics start working and strength returns. The good news is that tularemia is not known to spread from person to person, so the main impact on people around you is usually caregiving and concern rather than infection risk, although everyone should still avoid contact with contaminated animals, ticks, and other shared sources of exposure.
Treatment and drugs
Treatment for Tularemia usually relies on antibiotics, and starting them early can shorten illness and lower the risk of complications. Depending on how severe the infection is, treatment may be with pills at home or with antibiotics given by vein in the hospital, especially if someone has breathing problems, a high fever, or signs the infection has spread. Doctors may also treat symptoms with fluids, pain or fever medicine, and care for swollen lymph nodes or skin sores if these are causing discomfort. Not every treatment works the same way for every person, so the exact plan can depend on which part of the body is affected, how sick someone is, and whether early symptoms of Tularemia were recognized quickly. Even after treatment begins, follow-up matters because many living with Tularemia start to feel better within days, but fatigue and weakness can take longer to fully improve.
Can you cure Tularemia?
Yes, tularemia can usually be cured with the right antibiotics, especially when it is found and treated early. Most people recover fully, but severe cases may need hospital care to treat problems like trouble breathing, dehydration, or a widespread infection. Without treatment, tularemia can become very serious and, in some cases, life-threatening.
Non-drug treatment
Tularemia can make everyday life feel draining, with fever, swollen glands, skin sores, or a hard cough leaving many too tired for normal routines. While antibiotics are the main treatment for tularemia, non-drug care often helps people stay hydrated, breathe more comfortably, protect the skin, and recover strength. Beyond prescriptions, supportive therapies can be especially important during the early symptoms of tularemia and in more serious illness that needs hospital care.
Plenty of rest and regular fluids help the body cope with fever, sweating, and poor appetite. For many, this can mean sleeping more, sipping water or oral rehydration drinks, and taking small meals until strength returns.
If tularemia causes a skin ulcer, gentle cleaning and regular dressing changes can help the area heal and lower the chance of added infection. Keeping the sore covered and watching for increasing redness, drainage, or pain is also important.
Some people with tularemia develop swollen lymph nodes that soften, fill with pus, or become very painful. In those cases, a clinician may drain the area to relieve pressure and help healing alongside antibiotic treatment.
Lung involvement can make it hard to catch your breath, especially with pneumonia from tularemia. Oxygen, inhaled moisture, chest support, and close monitoring in the hospital may be needed until breathing improves.
Your genes may have an impact on how drugs work for you
For tularemia, treatment usually depends much more on the type of antibiotic, how sick someone is, and things like age, pregnancy, kidney health, and drug allergies than on inherited gene differences. At this time, there are no widely used genetic tests that help doctors choose tularemia treatment for most people, so genes are not a routine part of care here. In day-to-day life, this means that if one medicine is not a good fit, the reason is more often side effects, allergies, or how well the infection is responding, not a known inherited difference in how the body handles the drug.
Pharmacological treatments
Treatment for tularemia usually relies on antibiotics, and the choice depends on how severe the infection is and which body parts are affected. Many people improve with the right medicine, but severe tularemia often needs hospital care and drugs given by injection. When people search for antibiotics for tularemia, the main options doctors consider are gentamicin, streptomycin, doxycycline, and ciprofloxacin.
Gentamicin is one of the most commonly used treatments for tularemia, especially for severe illness or when someone is sick enough to need hospital care. It is usually given by vein or injection and is often chosen because it works well against the bacteria that cause tularemia.
Streptomycin has long been considered a standard treatment for tularemia and is often very effective. It is given by injection, but it may be used less often today because it can be harder to obtain than other options.
Doxycycline is an oral antibiotic that may be used for milder tularemia or when injection treatment is not needed. It can be a practical option, but relapse may be more likely than with gentamicin or streptomycin in some cases.
Ciprofloxacin is another oral option that is often used for mild to moderate tularemia and can also be used after initial hospital treatment. Not everyone responds to the same medication in the same way, so doctors may adjust the plan based on symptoms, test results, and recovery.
Genetic influences
If you develop tularemia after a tick bite, handling an infected animal, or breathing in contaminated dust, the main reason is exposure to the bacteria rather than something inherited from your parents. It’s natural to ask whether family history plays a role. For most people with tularemia, genetics does not play a major, proven role, and the illness is not considered an inherited disorder. Researchers do think that small differences in immune system genes may help explain why some people get sicker than others after the same exposure, but this is still an area of study and is not used in routine care. In practice, doctors focus much more on exposure history, symptoms, and quick treatment than on genetic testing when working out who gets tularemia and how severe it may become.
Is Tularemia genetic?
For tularemia, genetics are usually not the main factor. Getting infected depends much more on exposure, though small genetic differences in immune response may affect how severely some people with tularemia become ill.
Having a genetic risk is not necessarily a diagnosis
Genetic variants are a normal part of human biology and are found commonly in the general population. Most of these variants do not have a direct effect on health and are simply part of natural human diversity. For many genes, having a variant associated with a condition suggests a possible link rather than a definite diagnosis, especially when several genes and environmental factors are involved. In some cases, though, a single well-characterized variant in a particular gene can be enough to confirm a diagnosis.
Pharmacogenetics—how genetics influence drug effects
For most people with tularemia, genetics do not play a major role in choosing treatment right now. Doctors usually pick antibiotics for tularemia based on how severe the infection is, which part of the body is affected, your age, pregnancy status, and how well your kidneys are working.
Not every difference in response is genetic, but inherited differences can sometimes affect how your body handles certain antibiotics or how likely side effects are. In day-to-day care, though, doctors usually rely on your symptoms, kidney tests, and how you respond after treatment starts, rather than routine genetic testing for tularemia treatment. The genetics of the bacteria itself may matter more, since different strains can vary in severity and may respond a little differently to antibiotics. So if you are wondering why tularemia treatment works well for one person and needs adjustment for another, the answer is usually overall health and the infection pattern, with human genetics playing only a small part.
Interactions with other conditions
Tularemia can overlap with other illnesses in ways that make it harder to recognize at first. Its early symptoms of tularemia, such as fever, swollen lymph nodes, sore throat, cough, or a skin ulcer, can look a lot like the flu, strep throat, pneumonia, or other infections, so people may first be treated for something else. Another important aspect is how it may link with other diseases. In people with asthma, chronic lung disease, diabetes, or a weakened immune system, tularemia may hit harder and recovery can take longer, especially if it affects the lungs. Swollen lymph nodes from tularemia can also resemble conditions such as cat scratch disease or, less often, lymphoma, which may mean more testing is needed before the cause is clear. Because tularemia can sometimes lead to serious complications like bloodstream infection or meningitis, doctors usually consider someone’s other health problems, medications, and overall immune health when planning treatment.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
What other conditions can cause similar symptoms to Tularemia?
Tularemia can look like the flu, COVID-19, or other common infections at first because it often causes fever, chills, headache, and body aches. When it causes a skin sore and swollen glands, it may be mistaken for cat scratch disease, a serious skin infection, or another tick-borne illness, and when it affects the lungs, it can look a lot like pneumonia from other causes.
History
People living in rural areas once noticed a puzzling illness that could follow skinning rabbits, handling wild animals, or being bitten by ticks and deer flies. What we now call tularemia came into medical view in the early 1900s, after researchers investigating plague-like disease in ground squirrels in Tulare County, California, identified a different infection instead. Soon after, doctors realized the same germ could also make people sick.
As medical science evolved, tularemia was linked to several everyday exposure routes, which helped explain why one person might develop a skin sore and swollen glands while another had eye irritation, pneumonia, or a severe feverish illness. In the United States, it was sometimes called rabbit fever because many infections were tied to rabbits and hares. Careful work by physician Edward Francis greatly expanded what doctors knew about the disease, including how symptoms could vary and how infection could happen through insect bites, animal contact, contaminated food or water, or inhaling infected particles.
This history matters because early symptoms of tularemia can look like other infections at first, especially when the illness starts with fever, chills, body aches, and fatigue. Before modern testing and treatment, that made diagnosis difficult and recovery more uncertain. Over time, better laboratory methods made it easier to confirm tularemia, and antibiotics changed the outlook dramatically for many living with tularemia.
Today, tularemia is still considered uncommon, but it is well recognized by public health and infectious disease specialists in both the US and Europe. Its history is a reminder that some infections stay on doctors’ radar not because they are common, but because they can be serious if missed and because they often appear in very specific real-life settings, like hunting, farming, landscaping, or time spent in tick-heavy outdoor areas.