Tuleremia suspected in Wyomingites

[Niko]

Story available at http://www.billingsgazette.net/articles/2006/09/06/news/wyoming/50-tuleremia.txt

Published on Wednesday, September 06, 2006.
Last modified on 9/6/2006 at 1:02 am
Tuleremia suspected in Wyomingites

By The Associated Press
CHEYENNE - Two people are believed to have contracted tularemia, an infectious disease that animals and insects can spread to humans, according to the state Health Department.

Tularemia, also known as "rabbit fever" or "deer fly fever," typically affects rabbits, hares and rodents. Other mammals, including domestic animals, can also become infected.

A woman in Baggs who was bitten by a cat and a male youth in Lovell who recently skinned a rabbit are both believed to have contracted the disease, according to a Health Department news release Tuesday.

In addition, three cats, one foal and one cottontail rabbit have tested positive for the disease at the Wyoming State Veterinary Laboratory.

"We've had reports this year of large rabbit die-offs in a number of areas around the state," said Dr. Jaime Snow, state public health veterinarian with the Health Department.

People typically acquire tularemia when bit by an infected tick, deer fly, horse fly or mosquito; by handling infected animals; or through ingestion or contact with untreated, contaminated water or insufficiently cooked meat.

Human symptoms of tularemia can include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia.

If the bacteria are inhaled, symptoms can include abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough and progressive weakness.

"Tularemia can be fatal if the person is not treated," Snow said. "People who become ill after an insect or tick bite, after handling a sick or dead animal should contact their healthcare provider."

Copyright ? 2006 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Copyright ? The Billings Gazette, a division of Lee Enterprises.

 

[Marcie]

Re: Tuleremia suspected in Wyomingites

http://en.wikipedia.org/wiki/Tularemia



Tularemia
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Tularemia ICD-10 A21
ICD-9 021
DiseasesDB 13454
MedlinePlus 000856
eMedicine med/2326 emerg/591 ped/2327
Tularemia (also known as "rabbit fever") is an infectious disease caused by the bacterium Francisella tularensis. The disease is endemic in North America, and parts of Europe and Asia. The primary vectors are ticks and deer flies, but the disease can also be spread through other arthropods. Rodents, rabbits, hares and ticks often serve as reservoir hosts. The disease is named after Tulare County, California.

Contents [hide]
1 Mechanism of infection
2 Incubation period
3 Treatment
4 Biological Warfare
5 External links



[edit]
Mechanism of infection
Francisella tularensis is one of the most infective bacteria known; fewer than ten organisms can cause disease leading to severe illness. Humans are most often infected by tick bite or through handling an infected animal. Ingesting infected water, soil, or food can also cause infection. Tularemia can be acquired by inhalation; hunters are at a higher risk for this disease because of the potential of inhaling the bacteria during the skinning process. Tularemia is not spread directly from person to person.

Francisella tularensis is an intracellular bacterium, meaning that it is able to live as a parasite within host cells. It primarily infects macrophages, a type of white blood cell. It is thus able to evade the immune system. The course of disease involves spread of the organism to multiple organ systems, including the lungs, liver, spleen, and lymphatic system. The course of disease is similar regardless of the route of exposure. Mortality in untreated (pre-antibiotic-era) patients has been as high as 50% in the pneumoniac and typhoidal forms of the disease, which however account for <10% of cases. Overall mortality was 7% for untreated cases, and the disease responds well to antibiotics with a fatality rate of about 2%. The exact cause of death is unclear, but it is thought be a combination of multiple organ system failures.

[edit]
Incubation period
A patient with tularemia will most often develop flu-like symptoms between 1-14 days after infection (most likely 3-5 days.) If the patient was infected through an insect or tick bite, an eschar may develop at the bite site.

[edit]
Treatment
The drug of choice is Streptomycin. Tularemia can also be treated with gentamicin, tetracycline or fluoroquinolone antibiotics.

Practical research into using Tularemia as a bioweapon took place at Camp Detrick in the 1950s. It was viewed as an attractive agent because:-

it is easy to aerosolize
it is highly infective; fewer than 10 bacteria are required to infect
it is non-persistent and easy to decontaminate (unlike anthrax)
it is highly incapacitating to infected persons
it has low-lethality, which is useful where enemy soldiers are in proximity to non-combattants, eg civilians
The Centers for Disease Control and Prevention regard F. tularensis as a viable bioweapons agent for use by terrorists.

No vaccine is available to the general public. The best way to prevent tularemia infection is to wear rubber gloves when handling or skinning rodents (especially rabbits), avoid ingesting uncooked wild game and untreated water sources, and wearing long-sleeved clothes and using an insect repellant to prevent tick bites.

In summer 2000, an outbreak of tularemia in Martha's Vineyard resulted in one fatality, and brought the interest of the CDC as a potential investigative ground for aerosolized Francisella tularensis. Over the following summers, Martha's Vineyard was identified as the only place in the world where documented cases of tularemia resulted from lawn mowing. The research may prove valuable in preventing bioterrorism.

In 2004, three researchers at Boston University Medical Center were accidentally infected with F. tularensis, after apparently failing to follow safety procedures.

In 2005, small amounts of F. tularensis were detected in the Mall area of Washington, DC the morning after an anti-war demonstration on Sept. 24, 2005. Biohazard sensors were triggered at six locations surrounding the Mall. To this date, no cases of tularemia infection have been reported as a result. [1]

[edit]
Biological Warfare
By the late 1950's the US biological warfare program was focused mostly on tularemia as a biological agent. The Schu S4 strain was standardized as Agent UL for use in the M143 bursting spherical bomblet. It was a lethal biological with an anticipated fatality rate of 40 - 60 percent. The rate-of-action was around three days, with a duration-of-action of 1 to 3 weeks (treated) and 2 - 3 months (untreated) with frequent relapses. UL was streptamycin resistant. The aerobiological stability of UL was a major concern, being sensitive to sun light, and losing virulence over time after release.

The United States later changed the military symbol for UL to TT (wet-type) and ZZ (dry-type) in an effort to retain security on the identity of military biologicals. When the 425 strain was standardized as agent JT (an incapacitant rather than lethal agent), the Schu S4 strain's symbol was changed again to SR.

[edit]
External links
CDC Emergency Preparedness and Response index for tularemia
Soviet Army used 'rat weapon' during WWII
Biohazard Sensors Triggered Mall Germ Levels Likely Not a ThreatMartin Weil and Susan Levine Washington Post October 1, 2005
Health Officials Vigilant for Illness After Sensors Detect Bacteria on Mall Agent Found as Protests Drew Thousands of Visitors Petula Dvorak Washington Post October 2, 2005
US finds fever bacteria during war protest weekend Reuters Oct 3, 2005
Test Results Cited in Delay of Mall Alert CDC Explains Why Local Officials Weren't Told for Days About Bacterium Detection Susan Levine and Sari Horwitz Washington Post October 5, 2005
Detailed CIDRAP overview of tularemia, including fatality statistics
BioHealthBase Bioinformatics Resource Center Database of Francisella tularensis sequences and related information.
Retrieved from "http://en.wikipedia.org/wiki/Tularemia"
Categories: Infectious diseases | Zoonoses | Biological weapons

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[Christian Rivers]

Re: Tuleremia suspected in Wyomingites

CDC web site on Tularemia (aka rabbit disease, often found in rural areas)
http://www.bt.cdc.gov/agent/tularemia/
CR comments
Highlights: Category A bioagent (http://www.bt.cdc.gov/agent/agentlist-category.asp) highly infectious from the environment but usually not transmitted from person to person.. Good news,it is treatable with antibiotics.

FAQ
http://www.bt.cdc.gov/agent/tularemia/faq.asp
Q. What is tularemia?
A. Tularemia, also known as ?rabbit fever,? is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits, and hares. Tularemia is usually a rural disease and has been reported in all U.S. states except Hawaii.

Q. How do people become infected with tularemia?
A. Typically, people become infected through the bite of infected insects (most commonly, ticks and deerflies), by handling infected sick or dead animals, by eating or drinking contaminated food or water, or by inhaling airborne bacteria.
Q. Does tularemia occur naturally in the United States?
A. Yes. Tularemia is a widespread disease in animals. About 200 human cases of tularemia are reported each year in the United States. Most cases occur in the south-central and western states. Nearly all cases occur in rural areas, and are caused by the bites of ticks and biting flies or from handling infected rodents, rabbits, or hares. Cases also resulted from inhaling airborne bacteria and from laboratory accidents.
Q. What are the signs and symptoms of tularemia?
A. The signs and symptoms people develop depend on how they are exposed to tularemia. Possible symptoms include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia. If the bacteria are inhaled, symptoms can include abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough, and progressive weakness. People with pneumonia can develop chest pain, difficulty breathing, bloody sputum, and respiratory failure. Tularemia can be fatal if the person is not treated with appropriate antibiotics.
Q. Why are we concerned about tularemia being used as a bioweapon?
A. Francisella tularensis is highly infectious. A small number of bacteria (10-50 organisms) can cause disease. If Francisella tularensis were used as a bioweapon, the bacteria would likely be made airborne so they could be inhaled. People who inhale the bacteria can experience severe respiratory illness, including life-threatening pneumonia and systemic infection, if they are not treated.
Q. Can someone become infected with the tularemia bacteria from another person?
A. People have not been known to transmit the infection to others, so infected persons do not need to be isolated.
Q. How quickly would someone become sick if he or she were exposed to tularemia bacteria?
A. The incubation period (the time from being exposed to becoming ill) for tularemia is typically 3 to 5 days, but can range from 1 to 14 days.
Q. What should someone do if he or she suspects exposure to tularemia bacteria?
A. If you suspect you were exposed to tularemia bacteria, see a doctor quickly. Treatment with antibiotics for a period of 10-14 days or more after exposure may be recommended. If you are given antibiotics, it is important to take them according to the instructions you receive. All of the medication you are given must be taken.
Local and state health departments should be notified immediately so an investigation and infection control activities can begin.
Q. How is tularemia diagnosed?
A. When a person has symptoms that appear related to tularemia, the healthcare worker collects specimens, such as blood or sputum, for testing in a diagnostic or reference laboratory. Laboratory test results for tularemia may be presumptive or confirmatory. Presumptive (preliminary) identification may take less than 2 hours, but confirmatory testing will take more time, often 24 to 48 hours or longer depending on the methods that need to be used.
Depending on the circumstances, a person may be given treatment based on symptoms before the laboratory results are returned.
Q. Can tularemia be effectively treated with antibiotics?
A. Yes. Early antibiotic treatment is recommended whenever it is likely a person was exposed to tularemia or has been diagnosed as being infected with tularemia. Several types of antibiotics have been effective in treating tularemia infections. The tetracycline class (such as doxycycline) or fluoroquinolone class (such as ciprofloxacin) of antibiotics are taken orally. Streptomycin or gentamicin are also effective against tularemia, and are given by injection into a muscle or vein. Health officials will test the bacteria in the early stages of the response to determine which antibiotics will be most effective.
Q. How long can Francisella tularensis exist in the environment?
A. Francisella tularensis can remain alive for weeks in water and soil.
Q. Is there a vaccine available for tularemia?
A. A vaccine for tularemia was used in the past to protect laboratory workers, but it is not currently available.
Page last modified October 8, 2003