Tick-borne ‘rabbit fever’ spreads with cases reported near major metro area

Health officials on Long Island are warning residents about a rare but potentially serious tick-borne illness.

Three probable cases of tularemia — also known as “rabbit fever” — have been confirmed by the Suffolk County Department of Health Services (SCDHS).

“SCDHS currently has three probable cases of tularemia this year,” the agency said in a statement provided to local outlets. “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.”

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One case involved a 9-year-old patient who was bitten by a tick while playing outside, according to NBC4 New York. After the tick was removed, he later developed high fever, severe head and neck pain, swollen lymph nodes/glands, body aches and extreme fatigue.

After multiple doctor visits and nearly a month of illness, an infectious disease specialist diagnosed the boy with tularemia.

Although the family’s yard is home to wild rabbits, the patient’s mother said he never handled the animals. Doctors believe infected ticks likely fed on the rabbits before biting the boy, transmitting the bacteria, according to reports.

Caused by the bacteria Francisella tularensis, the disease commonly infects rabbits, hares and rodents. However, it is zoonotic, which means it can spread from animals to humans.

The bacteria is a “tier-1 select agent,” a classification given to agents and toxins that “present the greatest risk of deliberate misuse with significant potential for mass casualties or devastating effects to the economy, critical infrastructure or public confidence, and pose a severe threat to public health and safety,” per the CDC.

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Although tularemia remains rare, with 196 U.S. cases reported in 2023, the disease has become more common in recent years. CDC surveillance found 2,462 cases between 2011 and 2022 — a 56% increase in incidence compared with the previous decade (2001–2010).

Daniel Ruderfer, M.D., chief of the Division of Pediatric Infectious Diseases at Hackensack Meridian K. Hovnanian Children’s Hospital in New Jersey, believes that the increase in cases is mostly due to improved microbiology detection methods.

“The traditional method of confirming cases has historically been via growth in culture and antibody testing,” he previously told Fox News Digital.

“However, newer detection methods, such as PCR testing, are likely a major contributor to the increase in reported cases.”

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Humans can contract the disease through bites from deer flies or ticks, contact with infected animals, or exposure to contaminated water or aerosols, the same source stated.

Symptoms of tularemia can vary depending on the type of disease. General symptoms include chills, headache, malaise, fatigue, anorexia, myalgia, chest discomfort, cough, severe sore throat, vomiting, diarrhea, and abdominal pain, according to Ruderfer.

“Depending on the location of the infected bit or scratch, people can develop localized lymphadenopathy (enlarged lymph nodes) and a cutaneous ulcer at the infection site,” he said.

“Other manifestations include conjunctivitis, pneumonia and potentially even bloodstream infections.”

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The death rate from the disease is typically low, less than 2%, but the CDC noted that it can be as high as 24% in rare, severe cases.

Tularemia can be treated with antibiotics, but no vaccine is currently available.

“The infection is absolutely dangerous and potentially life-threatening if not treated with appropriate antibiotics,” said Ruderfer.

Those most at risk include children between 5 and 9 years of age, older men, American Indian and Alaskan Native people, and those living in central U.S. states, according to the report.

The general population is not at an “obvious” risk for infection unless they come into physical contact with an infected rabbit, tick or deer fly, the expert noted.

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Those who hunt or interact routinely with rabbits should see a doctor if they develop any concerning symptoms, he advised.

“Many factors might contribute to the higher risk for tularemia in this population, including the concentration of Native American reservations in central states and sociocultural or occupational activities that might increase contact with infected wildlife or arthropods,” the CDC wrote.