Health officials on Long Island are warning residents about a rare tick-borne illness, tularemia, following three probable cases, including one involving a 9-year-old boy with severe symptoms.
Health officials on Long Island are sounding the alarm about tularemia, a rare but potentially serious tick-borne illness, after three probable cases were reported this year. The Suffolk County Department of Health Services (SCDHS) confirmed the cases in a statement to local media.
“SCDHS currently has three probable cases of tularemia this year,” the agency stated. “Confirmation of a tularemia diagnosis requires a combination of laboratory testing and fulfillment of specific clinical or epidemiologic criteria. The laboratory testing to confirm a tularemia diagnosis may take several weeks.”
One of the reported cases involved a 9-year-old boy who developed severe symptoms after being bitten by a tick while playing outside. Following the tick’s removal, the child experienced high fever, severe head and neck pain, swollen lymph nodes, body aches, and extreme fatigue. After nearly a month of illness and multiple doctor visits, an infectious disease specialist diagnosed him with tularemia.
Despite the presence of wild rabbits in the family’s yard, the boy’s mother noted that he had not handled any of the animals. Medical professionals believe that infected ticks likely fed on the rabbits before biting the boy, thereby transmitting the bacteria.
Tularemia is caused by the bacterium Francisella tularensis, which primarily infects rabbits, hares, and rodents. However, it is zoonotic, meaning it can be transmitted from animals to humans. The Centers for Disease Control and Prevention (CDC) classifies the bacteria as a “tier-1 select agent,” indicating it poses a significant risk to public health and safety.
Although tularemia remains relatively rare, with 196 cases reported in the United States in 2023, the disease has become more common in recent years. CDC surveillance data indicates that there were 2,462 cases between 2011 and 2022, reflecting a 56% increase in incidence compared to the previous decade.
Dr. Daniel Ruderfer, chief of the Division of Pediatric Infectious Diseases at Hackensack Meridian K. Hovnanian Children’s Hospital in New Jersey, attributes this rise in cases to improved microbiology detection methods. “The traditional method of confirming cases has historically been via growth in culture and antibody testing,” he explained. “However, newer detection methods, such as PCR testing, are likely a major contributor to the increase in reported cases.”
Humans can contract tularemia through bites from infected ticks or deer flies, contact with infected animals, or exposure to contaminated water or aerosols. Symptoms can vary widely depending on the type of disease but generally include chills, headache, malaise, fatigue, anorexia, myalgia, chest discomfort, cough, severe sore throat, vomiting, diarrhea, and abdominal pain.
<p”Depending on the location of the infected bite or scratch, individuals may develop localized lymphadenopathy (enlarged lymph nodes) and a cutaneous ulcer at the infection site,” Dr. Ruderfer noted. “Other manifestations include conjunctivitis, pneumonia, and potentially even bloodstream infections.”
The death rate from tularemia is typically low, at less than 2%, but it can rise to as high as 24% in rare, severe cases. While the infection can be treated with antibiotics, there is currently no vaccine available.
“The infection is absolutely dangerous and potentially life-threatening if not treated with appropriate antibiotics,” Dr. Ruderfer emphasized. Those most at risk include children aged 5 to 9, older men, American Indian and Alaskan Native populations, and individuals living in central U.S. states.
According to Dr. Ruderfer, the general population is not at an “obvious” risk for infection unless they come into direct contact with an infected rabbit, tick, or deer fly. He advises anyone who hunts or regularly interacts with rabbits to consult a doctor if they develop concerning symptoms.
The CDC has noted that various factors may contribute to the higher risk of tularemia in certain populations, including the concentration of Native American reservations in central states and sociocultural or occupational activities that increase contact with infected wildlife or arthropods.
As health officials continue to monitor the situation, residents are urged to take precautions against tick bites and to be aware of the symptoms associated with tularemia.
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