About Tularemia
Tularemia is caused by Francisella tularensis, one of the most infectious bacteria known: a handful of organisms can cause disease. In the United States it spreads through the bite of the American dog tick, Rocky Mountain wood tick and lone star tick, through deer fly bites in the West, through skin contact with infected animals, by inhaling dust or aerosols (classically from mowing over a dead rabbit), by drinking contaminated water and by eating undercooked meat. It is not carried by the blacklegged ticks that spread Lyme disease. Cases are most common from May through September.
The illness takes different forms depending on how the bacteria got in. The ulceroglandular form, a skin ulcer plus swollen regional lymph nodes, is the most common after a tick or fly bite. The pneumonic form, from inhaling the bacteria, is the most serious. Symptoms begin 3 to 5 days after exposure, with a range of 1 to 14 days. Diagnosis is confirmed by growing the bacteria in culture, which requires warning the lab, or by a rise in antibodies between 2 blood samples taken 2 to 3 weeks apart; antibodies usually are not detectable until 2 to 3 weeks after symptoms start, so doctors treat on suspicion.
The CDC's current treatment table, revised in 2025, gives adults the options of ciprofloxacin or levofloxacin for 10 days, gentamicin for 10 days, or doxycycline for 14 to 21 days. Doxycycline alone should not be used for severe illness or when treatment has been delayed more than 2 weeks, and severe cases should start with gentamicin. Only some of these drugs are FDA-approved specifically for tularemia; the fluoroquinolones and gentamicin are used off-label. A vaccine is not generally available in the United States.
Common Symptoms of Tularemia
Recognizing the signs of Tularemia early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Fever, which can reach 104 degrees F, with chills and exhaustion
- A skin ulcer where the bacteria entered, with swollen, painful lymph nodes nearby (the most common form)
- Swollen glands without an ulcer, or a painful red eye with swollen glands near the ear
- Sore throat and mouth ulcers after eating or drinking something contaminated
- Cough, chest pain and trouble breathing in the pneumonic form, the most serious
- Diarrhea, vomiting and body-wide illness in the typhoidal form
Who Tularemia Affects
Anyone exposed, but more often males and children, likely because of hunting, landscaping and outdoor play. Hunters, trappers, landscapers who mow over animal carcasses, laboratory workers and people who handle wild rabbits, hares, rodents or muskrats are at higher risk. Tularemia does not spread from person to person. Francisella tularensis is also classed as a potential bioterrorism agent, which is why labs handle it with special care.
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FDA-Approved Treatments for Tularemia
There is currently 1 FDA-approved medication for Tularemia. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.
Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.
Help Paying for Tularemia Treatment
Charity funds and drugmaker programs for Tularemia, checked at the source.
- Vibramycin (Doxycycline) · Generic from many makers
Side Effect Explorer
Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.
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Diagnosis and Testing
Bacterial infection (Francisella tularensis) from ticks, deer flies or infected animals, diagnosed by culture or antibody tests; not genetic.
Trusted Tularemia Resources
Reputable organizations and medical references for learning more about Tularemia, including disease registries, foundation resources, and clinical guidelines.