As highly infectious tularemia moves outward from the central United States to coastal areas, clinicians should be aware of the bacterial infection’s clinical profile and its potential as a bioweapon.
Tularemia spreads through arthropod bites or inhaling its etiologic agent, Francisella tularensis; coming in direct contact with infected animal tissue; and consuming contaminated food or water. Federal agencies have designated F tularensis a Tier 1 select agent because it could cause substantial casualties if used in bioterrorism. Even though overall mortality is low—less than 2%—certain strains have higher rates, up to 24%.
Tularemia’s Coastal Creep. JAMA. 2014;311(5):458. doi:10.1001/jama.2014.41