General Principles

• Tularemia is caused by the gram-negative bacteria Francisella tularensis and is endemic to the South Central US. It is associated with exposure to infected animals (particularly rabbits) and transmitted via tick bite or aerosolized droplets.
• F. tularensis is one of the most infectious pathogens known, with as few as 10 organisms necessary to cause disease. Due to its extreme infectivity, ease of dissemination, and capacity to cause illness with subsequent death, tularemia is considered a potential bioterrorism agent.