Incidence of Tularemia in New York State

Abstract

THE apparent limitation of tularemia to certain sections of the United States is surprising in view of the great variety of animals and birds which have been shown to be susceptible to this disease. So far as can be determined, only 12 cases, enumerated in Table I, are known to have occurred in New York State, and 10 of them were attributed to the handling of rabbits either known or thought to have -been imported from other states. In but 1 instance (case No. 3) was a wild animal in this state, a deer, indicated as the source of the incitant. Since no reference has been found in the literature to this species having been infected with B. tularense, a brief history may be of interest. The patient, a man, frequently butchered and skinned animals, especially during the hunting season. He handled the carcasses of raccoons and hogs 2 days after the first symptoms developed, but the information obtained indicated that there had been no opportunity for infection from these or other animals for a considerable time prior to his illness. On November 8,1930, during a hunting trip, he injured his left index finger while handling his rifle. Later that day, he dressed a deer which he had shot, and, on November 10, skinned the animal. On November 13 and 14, he complained of feeling ill and thought he had grippe. Congestion and pus formation were noted at the site of the wound on his finger. Dr. A. L. Hayes of Willsboro, N. Y., the local health officer, was consulted about 3 weeks after the injury occurred.At that time, in addition to the lesion on the finger, which still persisted, a painful gland, approximately the size of a pigeon's egg, was noted in the left axilla. A clinical diagnosis of tularemia was made, and a specimen of blood, sent to this laboratory on December 2, agglutinated B. tularense in a 1:320 dilution.