20.3 Tularemia Example

Also found in the American southwest and most commonly in rabbits, the causative agent is Franciscella tularemia, a gram-negative cocci (6). This disease is not as virulent as anthrax and does not lead to death as rapidly as plague; however, it continues to be one of the highly monitored bioterrorism agents. It is not easily spread from person to person. It is typically spread through bites from insects carrying the organism. Spread through aerosolized droplets can occur and would result in an abrupt onset of high fever, chills, pharyngitis, and pneumonia. Risk of mortality would be approximately 30% or more. When traveling through endemic areas, it is important to wear clothing that covers all exposed areas and to use insect repellent. Those who hunt rabbits and other small mammals should be cautious when cleaning the carcasses.

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