Rabbit fever: How climate and habitat changes are fuelling a rare disease

Indianexpress.com spoke with Dr Palleti Siva Karthik Reddy, consultant in internal medicine at Koshys Hospital, to understand the spread, prevention, and treatment of tularemia — and whether it poses a concern for people in India.

“Rabbit fever, also known as tularemia, is a rare but serious bacterial infection caused by Francisella tularensis,” said Dr Reddy.

How is rabbit fever transmitted to humans?

Dr Reddy said tularemia can be transmitted through various pathways. “Direct contact with infected animals, such as rabbits, hares, or rodents carrying Francisella tularensis poses a significant risk, particularly for hunters and wildlife enthusiasts. Insect bites, especially from ticks in densely populated tick regions and deer flies, are another common transmission vector. Consuming contaminated food or water, such as untreated water or undercooked meat from infected animals, can also lead to infection. Inhaling contaminated dust or droplets, particularly in agricultural or laboratory settings, can result in pulmonary tularemia,” he said.

Common symptoms include a sudden high fever, with temperatures potentially reaching up to 104°F (40°C). (Source: Freepik)

Why are cases rising?

Early signs and symptoms of tularemia

Symptoms vary depending on the route of infection but typically appear three to five days after exposure, according to Dr Reddy. “Common symptoms include a sudden high fever, with temperatures potentially reaching up to 104°F (40°C), often accompanied by chills, fatigue, and body aches, which are early flu-like indicators. Swollen lymph nodes, particularly near the site of infection, such as under the arms or in the groin, are also common.”

There are four forms of this disease: ulceroglandular, glandular, pneumonic and typhoidal.

Differentiation and diagnosis

“Tularemia symptoms can resemble other conditions such as flu, pneumonia, or lymphadenitis. However, the presence of a skin ulcer or swollen lymph nodes in someone with recent exposure to wildlife or ticks serves as a key distinguishing feature for diagnosis,” said Dr Reddy.

Treatment

Tularemia is treatable with antibiotics, Dr Reddy said. Streptomycin and gentamicin are used as the first-line options, and doxycycline or ciprofloxacin are used for milder cases,” he said.

“Treatment typically lasts 10–21 days, ensuring high recovery rates and minimal complications if started promptly. However, delayed or untreated cases can lead to chronic infections, lung abscesses, pneumonia, or life-threatening sepsis. The mortality rate is 1–2 per cent with treatment but can rise to 30–60 per cent in severe, untreated cases.”

Should India be concerned?

According to Dr Reddy, tularemia is “extremely rare in India due to different ecological conditions and limited interaction with the primary reservoirs of Francisella tularensis.” However, the doctor said that awareness remains essential for those travelling to endemic regions or working in wildlife settings.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.