NAME: Francisella tularensis
SYNONYM OR CROSS REFERENCE: Pasteurella tularensis, tularemia, rabbit fever, deerfly fever, Ohara's disease, Francis disease
CHARACTERISTICS: Gram negative non motile coccobacillus, non-sporing, aerobic, requires cystine for growth, grows well on Legionella media (BCYE) and slowly on enriched (Columbia base) blood agar; two biovars, Jellison type A (highly virulent) and Jellison type b (mild disease)
PATHOGENICITY: Human tularemia presents as an indolent ulcer at site of infection, accompanied by swelling of the regional lymph nodes (ulceroglandular); sudden on set of pain and fever, fever generally lasts 3 - 6 weeks without treatment; inhalation may be followed by a pneumonic disease or primary systemic (typhoidal) picture; type B strains 5-15% fatality rate; type A strains approximately 35% mortality from pulmonary tularemia
EPIDEMIOLOGY: Throughout North America and continental Europe, Russia, China and Japan; all months of the year; higher in early winter during rabbit hunting season and summer when ticks and deerflies are abundant
HOST RANGE: Wild animals (rabbits) and birds; some domestic animals; humans
INFECTIOUS DOSE: 5 - 10 organisms by the respiratory route; 106 - 108 organisms by ingestion
MODE OF TRANSMISSION: Inoculation of skin, conjunctival sac or oropharyngeal mucosa with blood or tissue while handling infected animals, or by fluids from infected flies, ticks or other animals; bite of arthropods (deerfly, mosquito) and ticks; ingestion of contaminated food and drinking water; inhalation of contaminated dust; able to pass through unbroken skin; rarely through bites of animals
INCUBATION PERIOD: Related to virulence of infecting strain, size of inoculum (dose) and route of introduction; 1 - 14 days, usually 3- 5 days
COMMUNICABILITY: Not directly transmitted from person-to-person; unless treated, infectious agent may be found in blood during first 2 weeks of disease and in lesions for a month; flies infective for 14 days, and ticks throughout lifetime (2 years)
RESERVOIR: Over a hundred species of wild animals, especially rabbits, hares, muskrats, beavers and some domestic animals; various hard ticks; deerfly (Chrysops discalis), mosquito, and birds; rodent - mosquito cycle in Scandinavia and Russia
ZOONOSIS: Yes - handling infected rodents and other animals; bites from infected blood sucking arthropods; cat bites
VECTORS: Ticks, deerflies, fleas, mosquitos ( Russia)
DRUG SUSCEPTIBILITY: Susceptible to aminoglycosides, streptomycin, gentamycin, tobramycin and kanamycin (bactericidal) and tetracyclines, chloramphenicol (bacteriostatic); streptomycin for severe disease and tetracycline for less severe; gentamycin is drug of choice
DRUG RESISTANCE: Streptomycin resistance organisms have been described
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to many disinfectants - 1% sodium hypochlorite, 70% ethanol, glutaraldehyde, formaldehyde
PHYSICAL INACTIVATION: Susceptible to moist heat (121° C for at least 15 min) and dry heat (160-170° C for at least 1 hour)
SURVIVAL OUTSIDE HOST: Carcasses and organs - up to 133 days; grain dust; bedbugs - 136 days; rabbit meat - 31days; straw - 192 days; water - up to 90 days, infected rabbit meat stored frozen at -15° C has remained infective longer than 3 years
SURVEILLANCE: Monitor for symptoms; confirm by serological testing
FIRST AID/TREATMENT: Antibiotic therapy with streptomycin
IMMUNIZATION: Live attenuated vaccines available from CDC for occupational risk groups
PROPHYLAXIS: Treatment with antibiotic (tetracycline for 2 weeks is an effective prophylaxis when given after exposure)
LABORATORY-ACQUIRED INFECTIONS: Third most commonly reported; almost all cases involved tularemia research; few cases related to work with infected animals and their ectoparasites; 225 cases up to 1976 with 2 deaths
SOURCES/SPECIMENS: Lesion exudate, respiratory secretions, cerebrospinal fluid, blood, urine, tissues from infected animals and fluids from infected arthropods
PRIMARY HAZARDS: Direct contact of skin or mucous membranes with infectious materials, accidental parenteral inoculation, ingestion, and exposure to aerosols and infectious droplets
SPECIAL HAZARDS: Cultures have been more commonly associated with infection than clinical materials and infected animals
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment for activities with clinical materials; Biosafety level 3 practices, containment and facilities for all manipulations of cultures and for experimental animal studies
PROTECTIVE CLOTHING: Laboratory coat; impervious gloves when direct contact with infectious materials is unavoidable; gloves and gown (with tight wrists and tie in back), face masks for work with infectious materials in biosafety cabinet
OTHER PRECAUTIONS: Use impervious gloves when handling animals, especially rabbits
SPILLS: Allow aerosols to settle; wear protective clothing; gently cover spill with paper towels and apply 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontamination before disposal; incineration of animal carcasses; steam sterilization of other laboratory waste
STORAGE: In sealed containers that are appropriately labelled
Date prepared: March, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001
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