Humans are most often infected by tick bite or through handling an infected animal. Ingesting infected water, soil, or food can also cause infection. Tularemia can be acquired inhalationally; hunters are at a higher risk for this disease because of the potential of aerosolizing the bacteria during the skinning process. Tularemia is not spread directly from person to person. A patient with tularemia will most often develop flu-like symptoms between 1-14 days after infection (most likely 3-5 days.) If the patient was infected through an insect bite, an eschar may develop at the bite site.
Tularemia has been identified as a potential bioweapon by the Centers for Disease Control and Prevention (CDC). Because of its ability to be aerosolized and the extremely small number of bacteria needed to cause infection, it could be used against a dense urban population.
No vaccine is currently available to the general public. The best way to prevent tularemia infection is to wear rubber gloves when handling or skinning rodents (especially rabbits), avoid ingesting uncooked wild game and untreated water sources, and wearing long-sleeved clothes and using a insect repellant to prevent tick bites.