6-Month Vaccines: What You Should Know
Tularemia: The 'rabbit Fever' That Can Fatally Infect Humans
Disease name: Tularemia, also known as "rabbit fever" or "deer fly fever"
Affected populations: This disease is rare in the U.S. Between 2011 and 2022, 2,462 cases of tularemia were reported in 47 states, according to the Centers for Disease Control and Prevention (CDC).
Historically, human tularemia infections have been reported in every U.S. State except Hawaii. They are especially likely to occur in rural areas of Arkansas, Missouri, Oklahoma and Kansas, and they usually happen between May and September. Most cases occur in children, especially males.
Causes: Tularemia is an extremely infectious disease caused by Francisella tularensis bacteria. The microbe is found throughout the Northern Hemisphere and occasionally in the tropics and Southern Hemisphere.
Related: 'Unusual' beaver die-off in Utah caused by 'rabbit fever,' which can also infect humans
There are four types, or subspecies, of F. Tularensis, which differ in terms of their location and their propensity to cause severe disease. F. Tularensis type A, for instance, is the most dangerous type and is only found in North America.
As its nickname suggests, tularemia normally affects animals such as rabbits, hares and rodents, but humans can also become infected. This can happen in several ways: through the bite of infected ticks or deer flies; by drinking contaminated water; or via physical contact with an infected animal, including being bitten. As few as 10 to 25 individual bacterial cells can cause tularemia infection in humans.
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(Image credit: Live Science) An ulcer on a person's thumb that was caused by tularemia infection.(Image credit: CDC Public Health Image Library)Tularemia cannot be spread from person to person. People who participate in activities such as hunting, wildlife management, hiking and camping are at higher risk of tularemia than the average person.
Symptoms: The exact symptoms of tularemia in humans depend on where the bacteria enter the body, but infected individuals usually experience a fever up to 104 degrees Fahrenheit (40 degrees Celsius).
If F. Tularensis enters the body via the skin, infected people may also develop an ulcer at the site of infection, as well as swelling of their lymph nodes, particularly in the armpit or groin. People who eat or drink food or water contaminated with F. Tularensis may develop a sore throat, mouth ulcers and tonsilitis, or inflammation of the tonsils.
In the most serious cases of tularemia, in which people inhale dust or aerosols containing F. Tularensis, the disease may cause symptoms in the lungs, including chest pain, a cough and breathing difficulties. These symptoms can also arise if an F. Tularensis infection in other parts of the body is not treated and the bacteria then spread to the lungs.
Treatments: Tularemia can be treated with broad-spectrum antibiotics, meaning those that are capable of killing a wide variety of bacteria. This treatment can lower the death rate of the disease from between 5% and 15% to 2%. There is currently no vaccine against tularemia that is approved for use in the U.S.
People can take precautions to prevent tularemia, according to the CDC. These include using insect repellant while outdoors and wearing gloves when handling sick or dead animals.
Disclaimer
This article is for informational purposes only and is not meant to offer medical advice.
How To Treat Ear Infections
Viral or bacterial infections can occur in the middle of the ear. These often cause pain, inflammation, and fluid buildup. Treatment typically involves antibiotics.
Ear infections are the most common reason that children visit doctors.
Ear infections are also known as glue ear, secretory otitis media, middle ear infection, or serous otitis media. Outer ear infections are known as otitis externa or swimmer's ear.
Infections in the ear are well understood, and their common occurrence means that research is frequently carried out.
Fast facts about ear infectionsHere are some key points about ear infections:
An ear infection is a bacterial or viral infection of the middle ear. This infection causes inflammation and the buildup of fluid behind the eardrum.
The middle ear is an air-filled space situated behind the eardrum. It contains vibrating bones that convert sound from outside of the ear into meaningful signals for the brain.
Ear infections are painful because the inflammation and buildup of excess fluid increases pressure on the eardrum.
An ear infection can be acute or chronic. Chronic ear infections may permanently damage the middle ear.
Ear infections can cause varying symptoms. In young children and infants, it may be more difficult to identify some symptoms.
Typical ear infection symptoms may include:
If discharge is present, a person should speak with a healthcare professional.
Young children or infants may also:
Acute otitis media (AOM)
AOM is the most common and least serious form of ear infection. The middle ear becomes infected and swollen, and fluid is trapped behind the eardrum. Fever can also occur.
Otitis media with effusion (OME)
After an ear infection has run its course, there may be some fluid left behind the eardrum. A person with OME may not experience symptoms, but a doctor will be able to spot the remaining fluid.
Chronic otitis media with effusion (COME)
COME refers to fluid repeatedly returning to the middle ear, with or without an infection present. This leads to a reduced ability to fight ear infections and has a negative impact on hearing ability.
An ear infection often begins with a cold, flu, or allergic response. These increase mucus in the sinuses and lead to the slow clearance of fluid by the eustachian tubes. The initial illness will also inflame the nasal passages, throat, and eustachian tubes.
The role of eustachian tubes
The eustachian tubes connect the middle ear to the back of the throat. The ends of these tubes open and close to regulate air pressure in the middle ear, resupply air to this area, and drain normal secretions.
A respiratory infection or allergy can block the eustachian tubes, causing a buildup of fluids in the middle ear. Infection can occur due to bacteria or a virus.
The eustachian tubes of young children are smaller and more horizontal than in older children and adults. This means that fluid is more likely to collect in the tubes rather than drain away, increasing the risk of an ear infection.
The role of adenoids
The adenoid is a pad of tissue located at the back of the nasal cavity. They react to passing bacteria and viruses and play a part in immune system activity. The adenoids can sometimes trap bacteria, however. This can lead to infection and inflammation of the eustachian tubes and middle ear.
The adenoids are close to the openings of the eustachian tubes, and if they swell, they can cause the tubes to close. Children have relatively large adenoids that are more active than those of adults. These make children more likely to contract ear infections.
Testing for ear infection is a relatively simple procedure and a diagnosis can often be made based on symptoms and a physical exam.
The doctor will generally use an otoscope, an instrument with a light attachment, to check for fluid behind the eardrum.
A physician will sometimes use a pneumatic otoscope to test for infection. This device checks for trapped fluid by releasing a puff of air into the ear. Any fluid behind the eardrum will cause the eardrum to move less than normal.
If in doubt, the doctor may use other methods to confirm a middle ear infection.
Tympanometry
The doctor uses a device that seals off and adjusts the pressure inside the ear canal. The device measures the movement of the eardrum. This allows the physician to determine the pressure of the middle ear.
Acoustic reflectometry
This method works by bouncing sound against the eardrum. The amount of sound that is bounced back indicates fluid buildup levels. A healthy ear will absorb the majority of the sound, but an infected ear will reflect more sound waves.
Both acoustic reflectometry and tympanometry can help show fluid in the middle ear. However, they do not show whether the fluid is infected.
Tympanocentesis
If an ear infection has not responded well to treatment, a doctor may use tympanocentesis. This procedure involves creating a small hole in the eardrum and draining a small amount of fluid from the inner ear. This fluid can then be tested to determine the cause of the infection.
This procedure is generally done by a specialist and is only useful for adults and older children as it is done while awake.
In some cases, ear infections will clear on their own without antibiotics. However, ear infections that are severe and last longer than 2 to 3 days require antibiotics.
For most middle ear infections, healthcare professionals will typically recommend either delayed antibiotic prescribing or watchful waiting:
If the diagnosis is COME, then a healthcare professional may recommend ear tubes as a part of treatment.
Ear infections are a common issue, especially among children.
Symptoms may include fever, fullness in the ear, discharge, and pain inside the ear. Small children may also tug or pull at the ear and become irritable and restless.
Medical treatment often involves antibiotics. However, in many cases, ear infections clear on their own after a few days.
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