Controlling Spread of Tularemia

Table of Contents

A. Isolation and Quarantine Requirements

Standard Precautions.  Quarantine is not required.

B. Protection of Contacts of a Case

No prophylaxis for contacts to a case is necessary.  Standard Precautions for inpatients with a draining lesion or for pulmonary symptoms should be used.

C. Managing Special Situations

Reported Incidence Is Higher than Usual/Outbreak Suspected

If an outbreak is suspected, it should be reported immediately due to seriousness of illness and potential of intentional infection.

Exposure of a Laboratory Worker

Requires immediate reporting so prophylactic treatment may be implemented.

D. Preventive Measures

Environmental Measures

In general, environmental measures are unnecessary.  If contaminated water or food or agricultural materials are suspected, action should be taken in consultation with the Center for Acute Disease Epidemiology. 

Preventive Measures/Education

  • Hunters should wear gloves when skinning wild game, keep their hands/gloves away from their eyes and thoroughly wash their hands after handling wild game carcasses. Wild game meat should be cooked “well done” (to at least 150° F/65° C).
  • Drink only treated water when in wilderness areas to avoid bacterial and protozoan diseases that can be transmitted via surface water.
  • Use DEET-based insect repellents to reduce the possibility of fly or tick bites. Use insect repellants properly. Repellants that contain DEET (N,N-diethyl-m-toluamide) should be used in concentrations no higher than 15% for children and 30% for adults. Avoid overuse of DEET-based products; excess application can lead to adverse reactions. Remember, repellants should never be used on infants. Permethrin is a repellant that can only be applied onto clothing, not exposed skin.
  • Avoid tick-infested areas. In areas where contact with ticks may occur, individuals should be advised of the following:
    • Wear long-sleeved shirts and long, light-colored pants tucked into socks or boots.
    • Stay on trails when walking or hiking and try to avoid high grass.
    • After each day spent in tick-infested areas, check yourself, your children, and your pets for ticks. Parts of the body ticks like most include the back of the knee, armpit, scalp, groin, and back of the neck.
    • Promptly remove any attached tick using fine-point tweezers. The tick should not be squeezed or twisted, but grasped close to the skin and pulled straight out with steady pressure. Once removed, the tick should be drowned in rubbing alcohol or the toilet.
  • Notify laboratories when sending in specimens for possible cases are sent in for testing.

Iowa Dept. of Public Health, Reviewed 8/15