True Stories From The Disease Files

“Rabbit Fever” from a Tick Bite?

On May 2, 2004, a 13-year-old child from Northern Oklahoma developed symptoms of fever, headache, body aches, nausea, and vomiting.  In addition, the child had an open sore on the back of the knee and swollen, painful lymph nodes.  The patient was hospitalized for 24 hours and released following treatment with antibiotics.  The bacteria Francisella tularensis (F. tularensis) was isolated from the sore on the back of the knee confirming the child had contracted tularemia.  The child reported going for frequent walks by the creek located near their home and recalled being bitten by a tick within the two weeks prior to becoming ill.  The tick was attached to the back of the knee at the site where the open sore later developed.
Tularemia is an illness caused by an infection with the bacteria F. tularensis.  Tularemia was once commonly called rabbit fever because many of the cases had reported exposure to rabbits.  Although it certainly is possible to get tularemia from an infected rabbit, humans typically become ill 1-14 days following the bite of an infected tick.  The ticks associated with tularemia in Oklahoma are the dog tick and the lone star tick.  In addition, humans have also developed the disease following exposure to infected wild animals.  Although many wild and domestic animals have been infected, the rabbit is most often involved in disease outbreaks.  Other less common means of spread are drinking contaminated water; inhaling dust from contaminated soil; or handling contaminated pelts or paws of animals.  Tularemia is not spread from person to person.

Persons of all ages may experience one or more of the various forms of tularemia, which include: skin ulcer with or without swollen lymph nodes or infection of the eyes, throat, intestines, lungs, or blood.  Tularemia can be a severe and fatal disease, therefore it is important for treatment with appropriate antibiotics be started without delay.  Fortunately, this child was quickly taken to the doctor and treated with the appropriate antibiotics and made a full recovery.  

In 2005, 20 cases of tularemia were reported to the Oklahoma State Department of Health Communicable Disease Division and 19 cases in 2004, representing the highest numbers of cases reported over the past ten years.  Nationally, Oklahoma usually ranks behind only Arkansas and Missouri in the number of reported cases of tularemia each year.  The majority of tularemia cases occur in the months of May through October corresponding with the time of year when there are an increased number of ticks.

Please visit the following links for more information regarding tularemia:

ADS Resources:
Tularemia Fact Sheet  En Espanol
Tickborne Illnesses
Tularemia
Tickborne Disease Prevention

Other Resources:
CDC Tularemia
CDC Tickborne Diseases

Surveillance Resource:
Tularemia Summary Data