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Cause:
Bacterium
Francisella tularensis.
Illness and treatment: Symptoms
reflect the route of transmission and can include fever,
malaise, swollen lymph nodes, skin ulcers, eye infection,
sore throat, abdominal pain, diarrhea and pneumonia; any
infection can cause sepsis. Treatment is with antibiotics.
Sources:
The reservoir is wild mammals (especially rabbits, hares,
voles, squirrels, muskrats, beavers). Infection can occur
through direct contact with an infected animal, an arthropod
(e.g., tick, deerfly) bite, ingestion of contaminated raw
meat or water, or inhalation, including during outdoor work
or with improper handling of cultures in laboratories.
Prevention:
Wear gloves if skinning wild
game and keep hands or gloves away from the eyes. Drink only
treated water when in wilderness areas. In endemic areas
avoid tick and insect bites.
Recent Washington trends:
Each year there are one to 10 reports. Exposures include
insect and animal bites, contaminated water, and inhalation
while farming or landscaping with power tools. In 2004-2005
a statewide serosurvey of over 360 outdoor pet cats and dogs
found 0.6% exposed to tularemia overall but 4.5% exposed in
southwest Washington.
2008:
4 cases were reported in
state residents. Most had exposure to wild rabbits or
rodents.
Purpose of Reporting and
Surveillance
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To assist in diagnosis.
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When the source is a risk for only a few
individuals (e.g., animal exposure), to inform those
individuals how they can reduce their risk of exposure.
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To educate potentially exposed persons,
including laboratory personnel, about signs and symptoms of
disease, thereby facilitating early diagnosis.
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To determine the endemicity and epidemiology
of the disease in Washington state.
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To raise the index of suspicion of a
possible bioterrorism event if no natural exposure source is
identified.
Reporting Requirements
- Health care providers: notifiable to Local Health
Jurisdiction within 3 work days
- Hospitals: notifiable to Local Health Jurisdiction
within 3 work days
- Laboratories: specimen submission required
- Local health jurisdictions: notifiable to DOH
Communicable Disease Epidemiology within 7 days of case
investigation completion or summary information required
within 21 days. If bioterrorism is suspected, case must
be immediately reported to DOH: 1-877-539-4344
Last
update
November 2009 |
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