Increase in Tularemia cases necessitates immediate action, says CDC
Rising Tularemia Cases in the United States: A Call for Vigilance
The Centers for Disease Control and Prevention (CDC) has conducted a study on the rising cases of tularemia, a bacterial disease caused by Francisella tularensis. The study offers a valuable snapshot of the current situation, serving as a foundation for improving disease prevention and response efforts.
Tularemia is found across the U.S. and North America, including diverse wildlife hosts such as rabbits, rodents, beavers, and occasionally domestic cats and dogs. The geographic distribution of ticks, which transmit several diseases and play a role in tularemia spread, is expanding in many U.S. regions due to climate change and environmental factors like deer reintroduction and regenerating forests, facilitating wider spread of tick-borne diseases including tularemia. High-risk U.S. areas for tick encounters (and thus potentially tularemia risk) are the Northeast, Midwest, and parts of the Southeast.
Emerging tick species such as the Asian longhorned tick have been found in many eastern and midwestern states, capable of carrying serious pathogens though their role in tularemia transmission remains under study. The rise in tularemia cases is associated with expanded tick habitats and contact with infected wildlife, particularly rabbits.
Prevention focuses on limiting tick bites and wildlife exposure, along with public education and surveillance in endemic and emerging high-risk regions of the U.S. Avoid contact with wildlife, especially rabbits and rodents, and use protective gear when handling or hunting these animals. Use insect repellents and wear long sleeves and pants to minimize tick bites when outdoors in tick-infested areas, particularly in the Northeast and Midwest where tick activity is high. Conduct tick checks on skin and clothing after outdoor activities and promptly remove any attached ticks to reduce infection risk.
Educate at-risk populations (hunters, wildlife workers, pet owners) about tularemia transmission modes and symptoms for early detection and treatment. Monitor regional tick populations and wildlife infection rates to inform targeted public health measures. Public health surveillance continues to track tularemia and tick-borne diseases’ geographic spread to adapt prevention efforts accordingly.
Certain groups, such as children aged 5 to 9, older adults, and American Indian or Alaska Native populations, are more likely to contract tularemia. Tularemia can spread through insect bites, handling infected animals, drinking contaminated water, or inhaling airborne bacteria. The CDC expanded its testing criteria in 2017 to include polymerase chain reaction (PCR) techniques, leading to the identification of more probable cases.
Tularemia remains underreported due to differences in state-level reporting and surveillance practices. Bridging healthcare gaps, strengthening diagnostic capabilities, and promoting preventive practices are essential to reducing the impact of tularemia. Collaboration with local communities will be crucial in ensuring those most vulnerable receive the care and resources they need.
Tularemia cases have increased by 56% compared to the previous decade, with over 2,400 cases reported between 2011 and 2022. The study serves as a reminder of the need for continued efforts to improve disease prevention and response strategies. Antibiotics effectively treat tularemia, but early diagnosis is crucial to prevent serious complications.
The impact of the COVID-19 pandemic on tularemia data collection may have skewed the results of the study. Native populations experience rates of tularemia approximately five times higher than those of white individuals. Not all states follow consistent guidelines for documenting and investigating tularemia cases. Central states, including Arkansas, Missouri, Kansas, and Oklahoma, account for half of all reported tularemia cases.
As public health agencies refine their strategies, ongoing collaboration and communication will be vital in addressing the growing threat of tularemia. The rising incidence of tularemia underscores the importance of vigilance, especially in areas and among groups with the highest risk.
