Tularemia is a disease that does not usually occur in epidemic form. Ordinarily one sees only sporadic cases or at most only a very few cases infected from the same source. But with conditions sufficiently favorable it is a disease that may assume epidemic proportions. This study concerns such a situation, which arose in a Civilian Conservation Corps camp in northern Utah during the summer of 1935.
The history shows that this camp consisted of about 170 enrollees located on the treeless plains north of Great Salt Lake. The men were engaged largely in road construction, and because of the excessive heat many of them worked without shirts or other covering above the waist. July 11 one of the enrollees appeared on sick report with fever, headache, general malaise and enlarged tender lymph nodes in the right supraclavicular area. Approximately twenty-four hours later a punched-out, sloughing ulcer about 1 cm.
HILLMAN CC, MORGAN MT. TULAREMIA: REPORT OF A FULMINANT EPIDEMIC TRANSMITTED BY THE DEER FLY. JAMA. 1937;108(7):538–540. doi:10.1001/jama.1937.02780070022006
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