National case definition: Tularemia

Date of last revision/review: May 2008

National notification

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level

Case classification

Confirmed case

Clinical illness (see Clinical evidence section) with laboratory confirmation of infection:

Probable case

Clinical illness with laboratory evidence:

Clinical evidence

Clinical diagnosis is supported by evidence or history of a tick or deerfly bite, exposure to the tissues of a mammalian host of Francisella tularensis or exposure to potentially contaminated water.

Clinical illness is characterized by several distinct forms:

Ulceroglandular: cutaneous ulcer with regional lymphadenopathy

Glandular: regional lymphadenopathy with no ulcer; oculoglandular conjunctivitis with preauricular lymphadenopathy; oropharyngeal stomatitis or pharyngitis; or tonsillitis and cervical lymphadenopathy

Intestinal: intestinal pain, vomiting, and diarrhea; pneumonic primary pleuropulmonary disease; typhoidal febrile illness without early localizing signs and symptoms

ICD code(s)

ICD-10 code(s)


Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

Page details

Date modified: