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June 3, 2020

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  • Be aware of a case of tularemia in a King County child with onset of illness around April 30, 2020. The case was most likely exposed in East King County (on private property).
  • Tularemia can be difficult to diagnose because of the non-specific symptoms and because it is a rare disease.
  • Consider tularemia in patients with compatible symptoms and any likely exposures, including tick and deer fly bites, contact with sick or dead animals (especially in persons who perform landscape and farming activities).
  • Healthcare providers should be alert for tularemia infections among persons who may be at increased work doing outdoor activities or who have contact with sick (or dead) animals.
  • Report confirmed or suspected tularemia cases to Public Health at 206-296-4774.
  • Testing including blood tests and cultures (blood or wound) can help confirm the diagnosis.
  • Treatment: Typically with antibiotics including streptomycin, gentamicin, doxycycline and ciprofloxacin, typically for 10 to 21 days depending on the type of illness and the antibiotic used.
  • If tularemia is suspected, it is important to notify laboratory staff before/when specimens are submitted. Francisella tulerensis is highly infectious when grown in culture and laboratory-acquired infections have occurred.

On May 26, 2020, Public Health received a report of suspected tularemia case in a King County child whose family resides in a wooded area. The case had glandular tularemia and is recovering. The most likely exposures include a deer fly or tick bite.

The symptoms of tularemia and severity of disease vary depending on how the bacteria enter the body (through the skin, eyes, mouth or lungs). The types of tularemia include ulceroglandular, glandular, oculoglandular, orophyaryngeal, pneumonic, and typhoidal.

Exposure to tularemia can occur by inhaling dust or aerosols contaminated with the bacteria, Francisella tularensis, such as during farming or landscaping activities, especially when machinery runs over infected animals or carcasses. Exposure can also occur from a tick or deer fly bite, by handling infected animal tissue (hunting or skinning infected rabbits, muskrats, prairie dogs and other rodents), by a bite from a sick or dead animal, or by drinking or consuming contaminated water including recreational water exposure. Tularemia is not spread person to person.