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Tularemia is an infectious zoonotic disease, transmitted most often by rodents. The causative agent of this disease enters the human body usually through the wound caused by a bite or bite by a sick animal, occasionally through the conjunctiva. The disease is mainly found in Europe, the United States, Canada, Mexico and China. In Poland, it occurs rather endemically, in the northern parts of the country, mainly in the following voivodeships: Zachodniopomorskie, Pomorskie, Warmińsko-Mazurskie, Podlaskie, as well as Wielkopolskie and Kujawsko-Pomorskie
How does tularemia infection occur?
Infection with tularemia is spread mainly by rodents (it can be hares, rabbits, mice, musk mice, rats, less often by dogs, cats or birds), this disease occurs mainly in forested areas, steppes, etc. Animals become infected mainly by their parasites (ticks). , fleas, lice) and contaminated water. Man becomes infected with tularemia when bitten by the mentioned rodents, and also through arthropods, e.g. ticks, some species of flies, fleas, mosquitoes, etc., which are their parasites or act as carriers.
Infection with tularemia also occurs through the digestive tract, inhalation, through the skin or conjunctiva, and through contact, e.g. by rubbing tularemia germs into the conjunctival sac (occupational disease of hunters). The infectious agent is the stick Francisella tularensiswhich multiplies at the site of infection and in the nearest lymph nodes. The spread of bacteria to various organs occurs through the blood and lymph.
The hatching period for tularemia is 1-16 days.
Symptoms of tularemia
At the site of infection with tularemia, a papule develops into a pustule, followed by a crater-shaped ulcer. Local lesions are accompanied by intense general symptoms, such as:
- high fever,
- chills,
- headaches and muscle aches,
- vomiting.
Occasionally, a blotchy or papular rash appears on the skin, and conjunctivitis may also occur.
The liver and spleen can become enlarged during tularemia. We can distinguish several types of clinical tularemia, depending on where the germ has entered. If the infection affected the skin or mucous membranes, the crater-like ulceration at the site of entry of tularemia germs is then formed, and the surrounding lymph nodes increase in size and become inflamed, including “suppuration”.
Varieties of tularemia
1. Nodal form is the most common form of tularemia. The infection occurs as a result of contact with contaminated animal tissues or as a result of bites by infected ticks or mosquitoes. Symptoms include fever, muscle aches, headaches, and erythematous papules that eventually develop into ulcers.
2. Oculo-nodal form – appears when we clasp our eyes with our fingers, then the conjunctiva and lumps are ulcerated.
3. Gastro-intestinal form – it occurs when we consume contaminated food or water. Symptoms can be mild diarrhea or acute food with ulcers on the intestines.
4. Postać trzewna (durowata) – occurs with abdominal pain, diarrhea, nausea, and even vomiting, and high fever with general toxicity.
5. Angina form – the throat and mouth become inflamed, mucosa ulceration may appear. We most often become infected with this form of tularemia after eating contaminated food or water. The accompanying symptoms are muscle pain, temperature, enlarged lymph nodes, and pneumonia may also occur.
6. Pulmonary form – the most severe, with symptoms of interstitial pneumonia. Infection occurs through the respiratory tract. The accompanying symptoms are muscle aches, fever, chills, pharyngitis, dry cough or chest pain.
Tularemia – diagnosis and treatment
If tularemia is suspected, the following are collected from the patient:
- lymph node samples,
- fragments of skin lesions,
- urine,
- blood samples
- digestive tract material,
- swab of wounds and throat,
- pleural fluid,
- samples of contaminated food and water.
Antibiotics such as tetracyclines or aminoglycosides are used to treat tularmia. In addition, patients are taking other medications, such as netilmicin or gentamicin.
See also: Ornithosis – an infectious zoonotic disease