In the fall of the year, the doctors in the small towns in the neighborhood of good hunting districts may expect to have a patient or two come to them to see about a peculiar sore on one of his fingers or the back of the hand. The story is that this ulcer has been there a week or more, and doesn’t seem to want to heal and the part that really worries the patient is that the lymph nodes at the inner side of the elbow or in the armpit have swollen up and are red and painful.
The doctor who has had experience before will ask: “Have you been hunting rabbits lately?” and if the answer is in the affirmative will continue and ask: “Did you skin and dress the rabbits yourself?”
For the disease is tularemia, one of those transmitted directly from animal to man. It is very common in rabbits all over the country, and is also found in squirrel and quail. The germ is killed by cooking, so there is no danger in eating the flesh of the infected animals. But the germ easily enters the system through small cuts (or even the intact skin) when the fresh blood of the animal is touched, as in skinning or dressing.
Prevention is easy and consists in wearing rubber gloves while dressing wild game.
It is an occupational disease in that butchers and hunters are the regular recipients.
The form I have just described is the usual one. Sometimes the glands swell up without any apparent portal of entry on the skin, but this is usually because the little sore has healed up without being noticed.
Another form affects the eyes producing a superficial ulceration, and, in fact, some of the first cases were discovered by an oculist in Arizona. The infection is conveyed to the eye by rubbing the eye with infected fingers.
It is worth noting that a general practitioner, Dr. R. A. Pearse of Brigham City, Utah, reported cases of this kind from the bite of the deerfly as early as 1910. In fact, when I first heard the disease described, the speaker began by saying, “Here is a new disease fathered by a general practitioner, mothered by an oculist, and delivered by a U. S. public health laboratory worker.”
Tularemia in man is not serious in most instances, recovery being the rule in the vast majority of instances. But the disability is sufficiently uncomfortable and time-consuming to warrant observance of the method of prevention advocated above.