Tularemia is caused by the bacterium Francisella tularensis and can be transmitted by ticks; biting flies; handling tissues of infected animals; contaminated water, soil, and vegetation; and by inhalation of aerosols. The normal reservoirs are a variety of small mammals such as rabbits, hares, squirrels, voles, mice, and rats. As few as 10 organisms are thought to be capable of establishing an infection. Tularemia can infect the skin, mucous membranes, gastrointestinal tract, lungs, or disseminate throughout the body. It is not transmissible from person to person. Because the bacteria can be infectious via aerosol, it is classified as a Category A potential bioterrorism agent.
In 2004, there was one reported case of tularemia in Indiana. Figure 1 shows the number of reported tularemia cases (8) in Indiana for the five-year period 2000-2004. The female to male sex ratio is 1:10. This sex ratio most likely reflects the probable routes of infection: outdoor activities with exposure to ticks, or hunting rabbits or other small mammals.
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