Fourth case of tularemia identified on Long Island

A fourth case of tularemia, also known as rabbit fever, was confirmed on Long Island by the Suffolk County Department of Health Services on Thursday. Dr. Gregson Pigott, the department's commissioner, said the bacterium Francisella tularensis has caused three cases in 2023, four in 2024 and six in 2025.

Tularemia is transmitted primarily through bites from infected ticks or deer flies, and can also be contracted by handling contaminated animal tissue, inhaling contaminated dust, or drinking contaminated water, according to the Centers for Disease Control and Prevention. The disease does not spread from person to person.

"It's often called rabbit fever because hunters who shoot rabbits and then skin and eviscerate them can become contaminated by that close contact with their tissues," said Dr. William Schaffner, a preventive medicine professor at Vanderbilt University Medical Center.

Symptoms vary by exposure route but typically include sudden fever up to 104°F, chills, headache, body aches and fatigue, followed by a sore or ulcer at the bite site and swollen lymph nodes, explained Dr. Zoe Weiss, director of clinical microbiology at Tufts Medical Center. More severe forms can affect the eyes, throat or lungs, depending on how the bacteria entered the body.

Diagnosis can be challenging due to the rarity of the illness and symptom overlap with other conditions. Treatment relies on commonly used antibiotics, which have made the disease much more manageable than in the past.

The CDC advises preventive steps such as using EPA-registered insect repellents, wearing protective clothing, promptly removing attached ticks, avoiding contact with dead animals while mowing, and using gloves when handling wildlife. A vaccine for laboratory workers exists but is currently under FDA review and not widely available.