Tularemia

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TularemiaRabbit Fever
Francisella tularensis

• Michelle Lawrence
• Elizabeth Stolarczuk

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What is Tularemia?

• One of the most infectious pathogenic bacteria
  known
• Divided into two subcategories, type A (virulent)
  and type B (avirulent)
• Mortality rate as high as 30-60 without
  antibiotic treatment with, 2
• Sores, fever, aches, chills, weight loss,
  general incapacitation

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The Organism

• Small, nonmotile, aerobic, gram-negative
  coccobacillus
• Thin lipopolysaccharide-containing envelope
• Hardy, non-spore forming, survives for weeks at
  low temperatures in water, moist soil, hay,
  straw, decaying animal caracasses
• Type A common in North America
• Type B common in Europe and Asia, thought to be
  causative agent of all human cases

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History

• First discovered as a plaguelike disease of
  rodents in 1911
• Studied in Japan between 1932 and 1945, and also
  for military purposes in the West
• WHO 1969 study on F. tularensiss serious ability
  as a biological weapon
• Largest recorded airborne tularemia outbreak in
  1966-67 in Sweden

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Infection/Disease

• Can infect humans through the skin, mucous
  membranes, gastrointestinal tract, lungs
• Major target organs are lymph nodes, lungs,
  spleen, liver, kidney
• Symptoms vary with virulence of organism, dose,
  and inoculation site

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Viability in Biological Weaponry

• The Working Group on Civilian Biodefense
  concludes that a weapon using airborne tularemia
  would likely result 3 to 5 days later in an
  outbreak of acute, undifferentiated febrile
  illness with incipient pneumonia, pleuritis, and
  hilar lymphadenopathy.

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I know of no other infection of animals
communicable to man that can be acquired from
sources so numerous and so diverse. In short, one
can but feel that the status of tularemia, both
as a disease of nature and of man, is one of
potentiality. R.R. Parker
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Making Tularemia a Weapon

• An aerosol release would have the worst medical
  and public consequences
• Not spread from person to person
• Slower progression of illness and lower
  case-fatality rate than inhalational plague or
  anthrax
• Costs to society of 5.4 billion per every
  100,000 exposed persons

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Treatment and Precautions

• Mass casualty situation, oral doxycycline and
  ciprofloxacin are treatments of choice, and are
  contained in national stockpile
• Vaccination developed, live and attenuated, used
  to protect laboratorians, effective against the
  bacterium after 2 weeks
• No simple, rapid, reliable diagnostic tests in
  case of mass exposure available

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Sources

• Tularemia. Center for Civilian Biodefense
  Strategies, Johns Hopkins University. 24 October
  2002. http//www.hopkins-biodefense.org/pages/agen
  ts/agenttularemia.html
• Dennis, David T, MD, MPH. Tularemia as a
  Biological Weapon. The Journal of the American
  Medical Association. 24 October 2002.
  http//jama.ama-assn.org/issues/v285n21/ffull/jst1
  0001.html