acute infectious disease resembling plague, but much less severe. It was described in 1911 among ground squirrels in Tulare county, California (from which the name is derived), and was first reported in humans in the United States in 1914. The causative agent is the gram-negative bacterium Francisella tularensis. The disease is primarily one of animals; human infections are incidental. It occurs naturally in many types of wildlife. In the United States the rabbit, especially the cottontail (Sylvilagus), is an important source of human infection, but other mammals, birds, and insects also spread the disease. Human cases in Sweden and Norway have been transmitted by hares; in the Soviet Union, by water rats. F. tularensis has been found in some natural water sources, causing incidences of the disease in humans and animals. Tularemia can be spread to humans by the bite of an infected animal, by contact with blood or fine dust from the animal's body during skinning or similar operations, by the ingestion of infected animal products that have not been properly cooked, or by the bite of an insect, most commonly a deerfly, Chrysops discalis (the human disease is also called deerfly fever). Various ticks of the genera Dermacentor, Haemaphysalis, Rhipicephalus, Amblyomma, and Ixodes may be largely responsible for maintenance of the animal infection. In addition, the infection is transmitted from the adult tick to the egg, and both larvae and nymphs are infectious and form an insect reservoir of infection. No case of human-to-human contamination has been reported.
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