Tularemia, 2019

Tularemia is an acute illness caused by Francisella tularensis subspecies tularensis (type A) or holarctica (type B). Routes of transmission include arthropod bites (particularly ticks and deer flies), contact with infected animals, and exposure to contaminated water or soil. There are six main clinical forms of disease and all include fever: ulceroglandular, glandular, pneumonic, oropharyngeal, oculoglandular, and typhoidal.

In 2019, 2 cases were reported; 1 was culture-confirmed and 1 was a probable case. Both cases had ulceroglandular tularemia. One case had type B tularemia, and the other was diagnosed by serology only and had an unidentified subtype. Case ages were 25 and 69 years old; 1 was male. Neither case was hospitalized; both survived. One case likely was infected through a biting fly bite on his property in Washington County. The other case was likely infected by taking a sick rabbit out of his dog’s mouth.

From 2007 to 2019, 20 tularemia cases were reported, with a range of 0 to 6 cases annually. Twelve cases had ulceroglandular, 4 had glandular, 2 had pneumonic, and 2 had typhoidal tularemia. Nine of 14 cases with a known tularemia subtype had type B, and 5 had type A. The median age of cases was 42.5 years (range, 2 to 87). Eleven cases were most likely exposed through a tick or biting fly bite, 2 through water exposures, 2 through a cat scratch or bite, 2 were exposed by inhaling the bacteria, and 2 cases’ exposures could not be determined. Fifteen of 18 cases for which race was known were white, 1 was black, and 1 was American Indian/Alaskan Native, and 1 was Asian/Pacific Islander.

• Find up to date information at>> Tularemia
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2019