Tularemia is perhaps the rarest of the often-named co-infections. Tularemia is most often contracted from deer flies, rabbits and dogs but is also found to have come (rarely) from the American Dog Tick, Rocky Mountain Wood Tick, and Lone Star Tick.
Depending on the site of infection, tularemia has six characteristic clinical symptoms: ulceroglandular (the most common type representing 75% of all forms),glandular, oropharyngeal, pneumonic, oculoglandular, and typhoidal.
The incubation period for tularemia is one to 14 days.
Most human infections become apparent after three to five days
There is very specific blood test for to look for Francisella tularensis. A blood sample is sent to a lab, where it is examined for Francisella antibodies using a method called serology. This method checks to see if your body has produced substances called antibodies to a specific foreign substance (antigen), in this case Francisella tularensis.
Antibodies defend your body against bacteria, viruses, and fungi. If antibodies are present, they are in the serum of your blood. Serum is the liquid portion of blood. Depending on the lab, the titre number will determine whether it is a past infection or active infection. Just as with Lyme bacteria, the presence of antibodies does not mean an active infection. If a person has ever been exposed, that person will have antibodies present in their blood serum.
Banding in a blot test such as Igenex is meaningless, as there is no specific band related to Francisella tularensis
Titre (concentration of antibodies) for acute disease should be a four-fold increase of lowest discernible levels. In most labs that would be 1:160. Convalescent titres of 10-14 days may be necessary to confirm disease.