Tularaemia

Question 1

What is Tularaemia?

Answer 1

A disease caused by the bacterium Francisella tularensis.

Question 2

Is Tularaemia a notifiable disease?

Answer 2

Yes - urgent for labs and doctors.

Question 3

What types of Francisella tularensis are there?

Answer 3

Types A and B.

Question 4

What is the reservoir for Tularaemia?

Answer 4

Diverse range of mammals, including rodents, rabbits, and ringtail possums in Australia.

Endemic countries - type B also associated with water (streams, lakes), semi-aquatic animals, arthropods (incl. ticks)

Question 5

How long can Francisella tularensis survive in the environment?

Answer 5

Weeks to months.

Question 6

How is Tularaemia transmitted?

Answer 6

• Via eyes, skin, mouth, throat, lungs
• Contact with sick/dead animals, tick bites, contaminated water, undercooked meat, lab exposure, and inhalation of contaminated dust/aerosols

Question 7

What are the clinical features of Tularaemia?

Answer 7

Various syndromes.

• Ulceroglandular - most common; local ulcerative lesion
• Pneumonic - atypical PNA; CFR 60% untreated
• Typhoidal - severe disease, GI / systemtic Sx
• Oculoglandular - conjunctivitis, LA, acquisition via eyes

Question 8

What is the most common syndrome associated with Tularaemia?

Answer 8

Ulceroglandular syndrome.

Question 9

What are common symptoms of Tularaemia?

Answer 9

Headache, chills, nausea/vomiting, fever, lymphadenopathy.

Question 10

Who are high-risk groups for Tularaemia?

Answer 10

Those who have contact with possums, especially bites/scratches, and lab staff.

Question 11

What is the case definition for confirmed Tularaemia?

Answer 11

Isolation of the bacterium.

Question 12

What methods are used for diagnosing Tularaemia?

Answer 12

Culture, PCR, and serology.

Question 13

What is the incubation period for Tularaemia?

Answer 13

1-14 days, usually 3-5 days.

Question 14

Is Tularaemia common in Australia?

Answer 14

No, it is rare with only 4 human cases ever reported.

Question 15

Which type of Francisella tularensis is the most virulent?

Answer 15

Type A.

Question 16

What preventive measures can be taken against Tularaemia?

Answer 16

Avoid untreated surface water, insect bites, contact with dead animals, and ensure thorough cooking of meat.

In Australia, special care when handling sick / dead possums

Question 17

How are cases of Tularaemia managed?

Answer 17

Interview - DRSVECTA; esp exposure in 2 weeks prior to Sx: travel, animal exposure, farms, tick bites, natural drinking water sources, eating wild game / imported products
T - ABx (doxy), standard precautions
I - NA
E - Sx, transmission

Question 18

What is the first line treatment for Tularaemia?

Answer 18

Doxycycline.

Question 19

What should be done in the case of local acquisition of Tularaemia?

Answer 19

Environmental evaluation in conjunction with AgVic officials.

Question 20

Fill in the blank: Tularaemia is considered a high-risk agent for _______.

Answer 20

bioterrorism.

Question 21

True or False: Type B Francisella tularensis is associated with milder disease.

Answer 21

True.

Question 22

What are the key resources mentioned for Tularaemia management?

Answer 22

DH protocol (no SoNG)

Question 23

Who are considered contacts?

Answer 23

Exposed to same source as case.

Question 24

What is the purpose of monitoring contacts of a Tularaemia case?

Answer 24

To check for symptoms and provide early testing/management if they develop.

Question 25

T/F: Tularaemia is a rare disease in Australia

Answer 25

True - 4 cases ever: 3 possum exposure, 1 wildlife autopsy ## Footnote Type B isolated from ringtail possums in NSW

Question 26

Where is Tularaemia endemic?

Answer 26

* North America * Central Asia * Eastern / central Europe * Japan