A Brief History of Tularemia

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Tularemia, a disease that affects animals and humans, has been around since about the same time that the last species of mammoth became extinct. It has been attributed to outbreaks in ancient Canaan beginning in 1715 BC, after which it is believed to have continued spreading around the eastern Mediterranean. Historians believe that tularemia was used in the first recorded case of biological warfare, occurring during the wars in Anatolia that led to the fall of the Assyrian empire.

In modern times, Tularemia was first reported in 1912 by the U.S. Public Health Service and identified as dangerous to humans. It quickly became associated with hunters, cooks and agricultural workers, most likely because of the capacity of the disease to jump to humans from a variety of other animals.

The cause of Tularemia is the bacterium Francisella tularensis, an intracellular bacterium primarily infecting macrophages that spreads to multiple organ systems. Rabbits, hares and rodents are particularly susceptible to the disease and tend to die in large quantities during outbreaks. Before mortality, animal symptoms can, but do not necessarily include fever, cough, refusal to eat, diarrhea and vomiting. Some animals do not show any symptoms, but still die a sudden death. In humans, the mortality rate is significantly lower but virulence remains high.

Humans can become infected with Tularemia in several ways, including tick bites, direct contact with infected animals, ingestion of contaminated water, inhalation of contaminated air or even as a result of bioterrorism. Human symptoms depend on how the bacteria entered the body, but include fever, ulcers, inflammation of lymph glands, diarrhea, progressive weakness and others. Tularemia is rare in humans and therefore difficult to diagnose, usually testing is needed for a diagnosis. Once a diagnosis is reached, the infection is treated with antibiotics and most patients recover within 3 weeks.

Since Tularemia is quite virulent, very infectious and can become airborne, the use of this bacterium in bioterrorism is a looming possibility. The disease was recently in the news when there were hints of ISIS having plans to attack water supplies with the use of this bacteria. While there have been no more details issued on the matter, the threat that is created by this disease should not be taken lightly by citizens and scientists around the world. I believe that the best this we can do to take preventative action in case of a bioterrorism incident is work on developing a vaccine for the general public and perhaps developing antibiotics that will more effectively target the bacterium, shortening recovery times (which would be very useful in case of a mass infection event, for example due to bioterrorism).



Trevisanato, Siro Igino; The ‘Hittite plague’, an epidemic of tularemia and the first record of biological warfare, Medical Hypotheses, Volume 69, Issue 6, 1371 – 1374



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