An illness characterized by several distinct forms, including the following:
Clinical diagnosis is supported by evidence or history of a tick or deerfly bite, exposure to tissues of a mammalian host of F. tularensis, including via an animal bite, or exposure to potentially contaminated water.
Serial or subsequent cases of tularemia experienced by one individual should only be counted if there is an additional epidemiologically compatible exposure and new onset of symptoms. Because the duration of antibodies to F. tularensis is not known, mere presence of antibodies without a clinically-compatible illness AND an epidemiologically compatible exposure within 12 months of onset may not indicate a new infection, especially among persons who live in endemic areas.
A clinically-compatible case with supportive laboratory evidence.
A clinically-compatible case with confirmatory laboratory evidence.