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Public Health - Seattle & King County

Tularemia (Francisella tularensis)

Tularemia is caused by the bacterium Francisella tularensis which naturally infects animals, especially rodents, rabbits, and hares. People become infected by the bite of an arthropod (most commonly ticks and deerflies) that has fed on an infected animal, or by being bitten by an infected animal, handling infected animal carcasses, eating or drinking contaminated food or water, or by inhaling infected aerosols in a laboratory setting. The use of F. tularensis as a weapon of bioterrorism is of concern because it is highly infectious. As few as 10 to 50 organisms can cause disease.

Resources for the general public
Resources for health care providers
in King County

Purpose of surveillance:

  • To identify and eliminate sources of transmission including contaminated food and water
  • To identify cases caused by potential agents of bioterrorism

Tularemia Case Data in King County

Local epidemiology:

One case of ulceroglandular tularemia was reported in 2013 in an adult with an infected wound from a cat scratch. The case was likely exposed in King County and was not hospitalized.

One case of glandular tularemia was reported to Public Health in 2012 in an adult with cervical lymph node swelling and lymphadenopathy after participating in outdoor activities in Washington state outside King County.

In 2010 an adult was diagnosed with tularemia after developing an ulcer after outdoor activities in King County. In 2009, an adolescent falconer with a history of skinning rabbits was diagnosed after developing fever, headache, and a swelling on his right arm. Prior to 2009, the last case of tularemia in King County was reported in 2005 in a person who may have been infected from an arthropod bite while camping outside of King County.

Approximately 200 human cases of tularemia are reported annually in the United States, mostly in persons living in the south-central and western states. Each year in Washington state two to eight cases are reported. Identified exposures include farming and rabbit skinning.