The disease is usually transmitted to humans through direct contact with an infected animal carcass. The bacteria enters the body through an open cut, which becomes an ulcerous sore. It can also spread by a bite from an infected tick, flea, fly, or louse or by eating infected game animals. Symptoms are similar to those of influenza and include swollen and tender lymph glands in the armpits or groin, fever, headache, muscle pain, and weakness. Tularemia is diagnosed by a history of exposure to a wild rodent or carrier insects, the sudden onset of symptoms, and the presence of a skin lesion.
Diagnosis is confirmed by a blood test for antibodies against the bacteria.
Patients are treated with antibiotics and warm saline dressings for skin lesions. Infection confers lifelong immunity.