Tularemia is frequently called “rabbit fever” is a disease of many animals. Human infection is usually incidental and usually a result of tick bites or cleaning wild game. It is more common in rabbits, squirrels, muskrats and deer. It has also been found with deer flies, some mosquitoes as well as domestic animals such as cattle and sheep, which is rare. Considerably uncommon now in the Untied States, it did peak in approximately 1939 in the United States. Recently, the states that are still reporting cases, in fact, approximately 60-65% of all cases are from Arkansas, Missouri, Kentucky, Tennessee and Texas. On the West Coast, the common vector is biting flies. Men account for approximately 75% of all cases. This is due to their involvement in hunting, trapping, or butchering wild game. This can be obtained on the skin as well as being inhaled or eaten. Most common is skin tularemia. This will start out with a red, either flat or raised bump that appears about four to five days after cleaning or contact with the organism. That usually itches, and then is followed by an abrupt onset of fever, fatigue and chills. This can also be obtained by breathing in the bacteria, for example cleaning rabbits, blood being spattered in the air. You can get pulmonary or lung tularemia. It once was thought that if hunters would wait after the first freeze that they would have less of a chance of obtaining this, and that it would kill off the infected or sick animals. This is untrue. You can still obtain tularemia from a rabbit in December, January, or February even after the first freeze. A rash usually does occur in about 20% of individuals who have tularemia. Treatment is effective and the mortality rate is 1-2%. Antibiotics that are used that are very effective are Streptomycin and Gentamycin. Tetracycline has been used as an alternative for years, but at this time is not recommended.