Massachusetts officials issue tularemia precautions

Aug 1, 2006 (CIDRAP News) – For the seventh year in a row, cases of tularemia are being reported on Martha's Vineyard, where six cases of the rare respiratory form of the disease have occurred so far.

The Massachusetts Department of Public Health (MDPH) in a Jul 27 press release said that the patients, ages 33 to 67, became ill between May 13 and Jul 5. All have been successfully treated and are recovering. Four of the six are employed as landscapers.

The MDPH added that cases of tularemia have occurred on Martha's Vineyard every year since 2000, when an outbreak infected 15 people and caused one death.

Tularemia in the United States is usually linked to insect bites or handling carcasses of small animals, particularly rabbits. The disease is caused by the bacterium Francisella tularensis, one of the six biological agents deemed most likely to be used by terrorists.

A study by the Centers for Disease Control and Prevention and the MDPH found that people on Martha's Vineyard in whom tularemia developed appeared to get sick after breathing in contaminated dust, soil, or grasses while brush cutting, mowing, or performing other landscaping activities.

The annual tularemia outbreaks have stymied public health officials because they raise questions about the disease's reservoir and vector. Bioterrorism experts have a key interest in monitoring tularemia patterns in wildlife populations because it would better help them distinguish a natural outbreak from a human-caused bioterrorism outbreak. (See Aug 11, 2004 CIDRAP News article.)

Symptoms of tularemia vary depending on the route of exposure. The disease is not spread from person to person; however, the MDPH noted that a few people have gotten sick after bites from infected pet cats.

While landscapers should take precautions, anyone working outside near lawn mowing or brush cutting should be careful, said Bela Matyas, DPH, MDPH medical director for epidemiology, in the press release. Precautions include clearing the area of dead animal bodies before using landscaping equipment and using a respirator while operating the equipment.

Other prevention tips include avoiding contact with wild animals, their droppings, or their bodies; using gloves, a respirator, or eye protection when skinning or dressing wild animals; cooking wild game thoroughly before eating it; avoiding drinking water that may have been contaminated by wild animals; and protecting against exposure to ticks.

See also:

Jul 27 Massachusetts Department of Health press release on tularemia cases

CDC/MDPH article on tularemia on Martha's Vineyard [Full text]

CIDRAP overview of tularemia