Transmission is through the bite of arthropods (ticks and deerflies, also mosquitoes in Sweden, Finland, and Russia), direct contact with infected animals, aerosols generated by skinning/processing infected animals, and ingestion of contaminated food or water.

The average incubation period is 3 to 5 days. F tularensis can be transmitted to humans via various mechanisms:

  • Bites by infected arthropods (see References: Klock 1973, Markowitz 1985)
  • Direct contact with infected animals
  • Handling of infectious animal tissues or fluids (see References: Young 1969)
  • Ingestion of contaminated food, water, or soil (see References: Barut 2009, Greco 1987, Mignani 1988, Reintjes 2002, Willke 2009); murine models have confirmed that F tularensis is an effective oral pathogen and may pose a hazard, particularly to immunocompromised individuals, if ingested in contaminated food or water (see References: KuoLee 2007)
  • Possibly direct contact with contaminated soil or water
  • Inhalation of infectious aerosols, including dust from contaminated hay (see References: Dahlstrand 1971) and aerosols generated by lawn mowing and brush cutting (see References: Feldman 2001, Feldman 2003)
  • Exposure in the laboratory setting (eg, inhalation of infectious aerosols, handling cultures or other infectious materials, accidental percutaneous exposure) (see References: Overholt 1961, Pike 1976)

Person-to-person transmission has not been documented.

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