- Highly infectious after aerosolization.
- Infectious dose can be as low as 10-15 organisms.
- Person-to-person transmission does not occur.
- Incubation period is 3-6 days with range of 1-21 days.
- Aerosolization would most likely result in typhoidal tularemia, with pneumonic involvement.
- Typhoidal tularemia is a nonspecific illness, with fever, headache, malaise and nonproductive cough (mortality rates can be as high as 30-60%).
- Diagnosis requires high index of suspicion given nonspecific presentation.
- Bacterial cultures should be handled in a Biosafety Level 3 facility; isolation of organism can otherwise put laboratory workers at risk.
- Organism is difficult to culture and grows poorly on standard media. Cysteine-enriched media is required.
- Serology is most commonly used for diagnosis.
- Standard precautions. Respiratory isolation not required.
- Streptomycin (7.5 mg/kg IM q 12 hours x 10-14 days) or gentamicin (3-5 mg/kg/day IV or IM qd in 3 divided doses x 10-14 days) are the preferred antibiotics.
- Tetracyclines are alternative choices, although they are bacteriostatic and associated with higher relapse rates and must be continued for at least 14 days.
- Antibiotic prophylaxis is most effective if begun within 24-hours after exposure to aerosol.
- Tetracyclines are recommended for 14 days.
Our mission is to prevent disease and injury and create environments that promote and protect the community's health.