A rare disease that some researchers have linked to the mysterious plague referenced in the Bible has now been detected in New York.
Health officials say four cases of tularemia — commonly called “rabbit fever” — have been confirmed in Suffolk County on Long Island, as the US has recorded 64 infections nationwide so far this year.
Tularemia is a potentially dangerous infection caused by the bacterium Francisella tularensis. It can spread to humans through tick and deer fly bites, direct contact with infected animals, breathing in contaminated dust or drinking tainted water.
Although uncommon, the illness can come on suddenly with flu-like symptoms such as high fever, chills and profound fatigue. Patients may also develop painful swollen lymph nodes and sores near the spot where the bacteria entered the body.
When cases become severe, the bacteria can reach the lungs, triggering pneumonia, breathing problems and complications that may be fatal if treatment is not started quickly.
The New York State Department of Health cautioned that routine yardwork can pose a risk if lawn mowers or landscaping equipment disturb contaminated animal remains and aerosolize the bacteria.
Residents have been urged to inspect their yards for dead animals and wildlife nests before mowing, and officials said wearing a mask during landscaping may help reduce exposure.
Dr Andrew Handel, a New York-based board-certified pediatric infectious disease specialist, told Our News Outlet: “If you inhale tularemia, it goes into your lungs and causes severe pneumonia, and again, that can make you critically, critically ill.”
The rare infection causes sudden flu-like symptoms, including high fever, chills and extreme fatigue, along with painfully swollen lymph nodes and sores near the point where the bacteria entered the body
The cases have emerged in Suffolk County, which includes the Hamptons, the exclusive seaside playground known for its celebrity residents, private clubs and multimillion-dollar estates.
Handel warned that tularemia can be difficult to diagnose because its symptoms vary depending on how the bacteria entered the body.
‘It’s a really tricky disease because it has so many different forms, and it’s rare, so it’s not at the top of our mind often when patients do come in,’ he said.
Rabbits and rodents are frequent carriers, although infected ticks can transmit the bacteria without a person ever touching a sick animal.
Someone who touches an infected animal and then rubs their eyes can develop painful redness and swelling, while swallowing the bacteria through contaminated food or water can cause an intestinal infection, Handel explained.
In either case, the infection can spread to other parts of the body.
Tularemia rarely spreads between people, meaning exposure typically occurs separately through infected animals, insects or contaminated environments.
‘I wouldn’t say [human transmission is] impossible, but it’s very uncommon to happen,’ Handel said.
Nine-year-old John Detmer (bottom left) spent weeks battling a serious case of rabbit fever after an infected tick latched onto his scalp earlier this year, his family said
The New York State Department of Health warned that people can become infected while mowing lawns or landscaping if equipment disturbs contaminated animal remains and sends bacteria into the air
‘In the hospital, often there’s a lot of precaution because we’re dealing directly with someone who’s infected.
‘If you’re around someone who’s known to be infected, obviously you want to be careful and not touch the wound [or] come in close contact with it.’
Some researchers have suggested tularemia may have caused the mysterious plague of tumors that struck the Philistines after they captured the Ark of the Covenant in the Book of Samuel.
However, the Bible does not identify the disease, and experts have proposed several competing explanations for the ancient outbreak.
The fourth case of rabbit fever on Long Island was confirmed this month.
Health officials have released few details about the patients, although they confirmed that a woman from Riverhead is being treated for tularemia.
Nine-year-old John Detmer spent weeks battling a serious case of rabbit fever after an infected tick latched onto his scalp earlier this year, his family said.
‘It’s like painful, like my neck was hurting me. Sometimes my legs would,’ the boy told News4. ‘It hurt it really bad when I touched it.’
His mother, Tracey Detmer, said the family did not initially realize the wound on John’s scalp was connected to his illness.
Even the infectious disease specialist treating him had encountered tularemia only once before during his career, she said.
After enduring 11 days of fever and intense pain around the wound, John finally began recovering following several courses of antibiotics, according to his family.
Handel said patients often begin improving within several days of starting antibiotics, although some continue experiencing fatigue, headaches and a general sense of being unwell after the bacteria have been eliminated.
Experts warned that pets could carry the bacteria and spread it to their owners
Tularemia cases are most commonly detected during spring, summer and fall, when ticks and rabbits are active and people spend more time outdoors.
‘Obviously, the year’s not over, we’re still in the heat of the summer,’ Handel warned.
‘If there are many more cases, it’s possible it’ll be more than typical.’
However, Suffolk County generally records between three and six cases annually, meaning the four infections identified so far remain within the usual range.
Handel also pointed to a notorious outbreak around Cape Cod in 2000, when several people reportedly became infected after lawnmowers struck dead rabbits and blasted contaminated particles into the air.
He explained that breathing in those particles allowed the bacteria to enter victims’ lungs, causing a particularly dangerous form of the disease.
Despite the disturbing routes of transmission, Handel stressed that tularemia remains extremely rare.
‘This is not something that I think people need to have excessive alarm about,’ he said. ‘When we think about tick-borne infections, it’s among the most rare that occur.’
He added that tick bites are likely the most common route of infection on Long Island, where large and highly active tick populations are widespread.
Residents should use insect repellent, avoid tall grass and leaf litter, treat clothing with permethrin and seek medical attention if they develop a fever or other illness in the weeks after a tick bite, Handel said.
