Table 1:

Overview of tularemia1^–4^,7

Consideration	Key point
Pathogen	Francisella tularensis subspecies tularensis and subspecies holarctica
Relevant exposures	Tick or deerfly bite, contact with an infected animal, ingestion of contaminated food or water, occupational exposure (e.g., farmers, hunters, veterinarians, landscapers, meat handlers and laboratory workers), travel or area of residence (typically occurs as a rural disease)
Incubation period	Average of 3–5 d, range of 1–21 d
Seasonality	Most commonly acquired during the summer months
Classic clinical syndromes	Ulceroglandular (most common), glandular, oculoglandular, pharyngeal, typhoidal, pneumonic
Diagnostic criteria	Confirmed case Compatible clinical presentation and either recovery of F. tularensis on culture from an appropriate clinical specimen or a fourfold or greater change in F. tularensis serum antibody titres Probable case Compatible clinical presentation and one of the following: detection of F. tularensis in a clinical specimen by a fluorescent assay, a single serum sample (serology) with a microagglutination titre of ≥ 1:128 or a tube agglutination titre of ≥ 1:160, or detection of F. tularensis nucleic acid with a molecular assay
Treatment	Severe disease Gentamicin or streptomycin Mild-to-moderate disease Ciprofloxacin or doxycycline