Increasing Incidences of Tularemia Warrant Immediate Response, States CDC

Increase in Tularemia Cases Highlights Need for Improved Prevention and Response Strategies

A recent study conducted by the Centers for Disease Control and Prevention (CDC) has revealed a significant increase in tularemia cases between 2011 and 2022, with over 2,400 cases reported during this period. The study, which emphasizes the need for consistent monitoring and improved data collection, found a 56% increase in tularemia cases compared to the previous decade.

Tularemia is a bacterial disease caused by Francisella tularensis and can cause a range of symptoms including fever, skin ulcers, and severe respiratory issues. The study found that certain groups, particularly children aged 5 to 9, older adults, and American Indian or Alaska Native populations, were more likely to contract tularemia. Native populations experienced rates approximately five times higher than those of white individuals.

The study also found that factors such as geographic location, occupational exposure, and environmental conditions likely play a role in these disparities. The central states of Arkansas, Missouri, Kansas, and Oklahoma accounted for half of all reported tularemia cases, highlighting the importance of vigilance, particularly in areas with the highest risk.

The increase in cases may be due to better diagnostic methods, specifically the use of polymerase chain reaction (PCR) techniques by the CDC since 2017. However, the impact of the COVID-19 pandemic on data collection during 2020 and 2021 may have skewed tularemia results.

Current strategies for prevention and treatment of tularemia focus on minimizing exposure to vectors and reservoirs, educating at-risk populations, and timely antibiotic treatment. To avoid tick and insect bites, it is recommended to use insect repellents, wear long sleeves and pants, and treat gear to repel ticks and flies. Avoiding handling sick or dead animals that may carry the tularemia bacterium is also crucial, as is checking for ticks promptly after outdoor activities and removing them safely and quickly. Cooking food thoroughly and using safe water sources are also important to prevent ingestion transmission pathways.

Environmental management, such as safely disposing of animal carcasses and monitoring for die-offs in wildlife like rabbits or rodents, which are natural reservoirs, is particularly important in rural settings. Health education and awareness tailored to local communities to recognize symptoms early and reduce risky behaviors is also essential.

Tularemia is treated with specific antibiotics, usually for 10 to 21 days depending on disease severity and stage. Common effective antibiotics include streptomycin, gentamicin, doxycycline, and ciprofloxacin. Early diagnosis and treatment are crucial to prevent complications, but challenges in rural or tribal areas include limited healthcare access and provider awareness, which may delay care. No vaccine is commercially available yet, though promising vaccine candidates are in preclinical stages.

Because rural and tribal areas may have limited healthcare infrastructure and diagnostic availability, low healthcare provider awareness, and possible delayed reporting and treatment access, strategies emphasize community engagement, public health reporting, and vector control alongside clinical management. Bridging healthcare gaps, strengthening diagnostic capabilities, and promoting preventive practices are essential to reducing the impact of tularemia.

The study calls for ongoing efforts to refine public health strategies and address the challenges in understanding and addressing the growing tularemia threat. Collaboration with local communities will be crucial in ensuring those most vulnerable receive the care and resources they need. The study provides a valuable snapshot of the current tularemia situation, serving as a foundation for improving disease prevention and response efforts.

References:

CDC Tularemia
CDC Tularemia in the United States
Appili Therapeutics Announces Positive Preclinical Data for ATI-1701, its Lead Tularemia Vaccine Candidate