Tuesday, February 19, 2013 11:45 PM
Area hunter contracts rabbit fever; officials encourage safety precautions
By Jon Jimison | Times Editor
The N.C. Wildlife Commission and state Division of Public Health are encouraging hunters to take precautions after a rabbit hunter in eastern North Carolina tested positive for a rare but serious disease called tularemia, also known as rabbit fever.
A second member of the same hunting party also showed signs of the disease.
"We’re just asking hunters to take precautions and be aware,” said Carolyn Rickard, spokeswoman for the N.C. Wildlife Commission.
Rabbit hunting season in North Carolina runs from Nov. 17 to Feb. 28.
Both hunters appear to be recovering, the commission noted.
Although rare, rabbit fever is a serious and potentially fatal disease. It’s also one where preventative measures can be taken.
Marilyn Haskell, public health veterinarian and epidemiologist with the N.C. Division of Public Health, said the division’s role is to prevent diseases and its employees would like to get a prevention and education message out to the public.
Tularemia is a disease caused by the bacterium Francisella tularensis, according to the Centers for Disease Control and Prevention. It’s typically found in animals, especially rodents and rabbits. Most cases occur in rural areas.
There have been 17 cases reported in North Carolina since 1999.
"That is combined, confirmed and probable,” said Haskell, who specializes in rabies and zoonotic diseases. "It can make you very, very sick. We want hunters to know you can get very sick and the rabbit can appear very normal.”
There are about 200 cases reported annually in the United States.
The disease has a 30 percent mortality rate in some forms if left untreated.
It’s treated with antibiotics, Haskell said.
All cases this year in North Carolina have been confined to the current investigation.
Officials said they wouldn’t name the eastern North Carolina county where the disease was reported due to patient confidentiality concerns.
"Our public health message is the same,” for every county in North Carolina, said Haskell, of the state’s Medical Consultation Unit.
"Wear impervious (such as waterproof) gloves when handling all animals live or dead,” Haskell said.
The bacteria that causes tularemia can be transmitted to humans through bites from insects such as ticks, Haskell said. It can also be transmitted through handling infected carcasses such as rabbits.
It can be transmitted by eating infected food, such as rabbit meat that hasn’t been cooked to 170 degrees or drinking water contaminated by an infected carcass.
The disease can even be transmitted through the air. Health officials caution against mowing over areas with dead animals.
Cats and dogs are also susceptible to the disease.
If your pet is sick, take it to your veterinarian without delay; wear impervious gloves when handling pets if they are sick.
People can protect their pets by not feeding them raw or undercooked rabbits. Veterinarians can recommend insect repellent.
Diagnosing rabbit fever through a patient’s symptoms can be difficult. Generally, a lot of infectious diseases initially appear similar, officials said.
Possible symptoms include skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia, according to the CDC. If the bacteria are inhaled, symptoms can include abrupt onset of fever, chills, headache, muscle aches, joint pain, dry cough and progressive weakness. People with pneumonia can develop chest pain and difficulty breathing.
It’s important to let your doctor know of any potential animal exposure, Haskell said.
"It’s very important for people to tell their physician about animal contact or insect bites,” Haskell said.
Tularemia can be diagnosed through a blood test of clinical specimen in a doctor’s office.
It’s not believed to be transmitted from person to person.
But it’s highly infectious and there is even concern, according to the CDC, about the bacteria’s potential use as a bioweapon.
"If Francisella tularensis were used as a bioweapon, the bacteria would likely be made airborne so they could be inhaled,” according to CDC information.
Tularemia was actually removed from the list of nationally notifiable diseases in 1994, but increased concern about its potential use as a biological weapon led to its reinstatement in 2000, according to CDC reports.
Haskell recommends using separate cutting boards, plates and utensils for raw, uncooked produce and for raw meat, poultry, seafood and eggs. Other tips include the following:
• Use impervious gloves when skinning, handling, and preparing meat for food.
• Wear gloves during food preparation.
• Cook all meat thoroughly and to 170 degrees
• Do not eat raw or undercooked meat
• Wash your hands thoroughly with soap and water after handling meat and animal carcasses
Outdoor enthusiasts can use insect repellent, Haskell said. They shouldn’t approach, feed or handle wildlife.
Here are other tips Haskell offered:
• If you cut yourself or if you are bitten by an animal, first wash the wound thoroughly for 15 minutes with soap and water, then seek medical care.
• If you develop a fever (signs of the flu), and/or ulcer, skin infection, enlarged lymph nodes or other unusual symptoms, seek medical attention as soon as possible
• Provide your health care provider with a thorough history of animal and insect contact and exposures
• Wear dust masks when mowing or stirring up dirt, hay, or dust and while in animal pens
State communicable disease health statistics recorded three cases in 2010. They also recorded a case in 2009 and three cases in 2008. There was an average of one case a year from 2005 to 2009.
Historically in the U.S., most cases of tularemia occurred in summer, related to insect bites, and in winter, related to hunters coming into contact with infected rabbits, according to CDC reports.
Tularemia was first detected in the U.S. in 1911 and has been reported from all states except Hawaii.
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