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Francis' disease

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Most commonly called tularemia. It is an infectious, plague like, zoonotic disease caused by infection with the bacillus Francisella tularensis. It is found primarily in rodents but also affects humans and many other animals; rabbits, squirrels, and muskrats are the primary source of infection.

It is transmitted to man from animals (chiefly rabbits) by contact with diseased or dead animals, by the bites of deer flies, fleas, and ticks; by contact with contaminated animals or their products; by ingestion of contaminated food or water or by inhalation of aerosolized bacteria. It may also be transmitted by housecats through bites and scratches. It is particularly seen in rabbit hunters in Russia and North America.

The symptoms consist of the sudden onset of chills, fever, weakness, and headache, and backache, prostration, vomiting, and sweating. The Japanese form, Ohara's disease, is also called yato-byo, meaning rabbit fever. There are clinical differences between the Yato-Byo observed in Japan and the tularaemia observed in the United States.

Most commonly called tularaemia after Tulare County, California, where it was first described in America in 1911 by the Utah physician R. A. Pearse as deer fever, and by George Walter McCoy (1876-1952) as a plague like illness. McCoy and Charles W. Chapin described the causative agent, Bacterium tularense, which was later renamed Pasteurella tularensis, now Francisella tularensis.

The disease was first described by the Japanese physician Homma Soken in 1837 as a febrile illness with generalized lymphadenopathy among people who had eaten infected rabbit meat.


  • Homma Soken:
    [Handbook of Surgery.] 1837.
  • R. A. Pearse:
    Insect bites. Northwest Medicine, Seattle, 1911, new series 3: 81.
  • G. W. McCoy:
    Plague-like disease in rodents.
    Public Health Bulletin, Washington DC, 1911, 43: 53-71.
  • G. W. McCoy, Charles W. Chapin:
    Further observations on a plague-like disease of rodents with a preliminary note on the causative agent, Bacterium tularense.
    The Journal of Infectious Diseases, Chicago, 1912, 10: 61-72.
  • G. W. McCoy, C. W. Chapin:
    Studies of plague, a plague-like disease, and tuberculosis among rodents in California. Public Health Bulletin, 1912, 53: 3-23.
  • G. W. McCoy, C. W. Chapin:
    Bacterium tularensis, the cause of a plague like disease of rodents.
    Public Health Bulletin, 1912, 53: 17-23.
  • William Buchanan Wherry (1875-1936) and Benjamin Harrison Lamb (1889-1983):
    Infection of man with Bacterium tularense.
    The Journal of Infectious Diseases, Chicago, 1914, 15: 331-330.
  • E. Francis:
    Tularemia. Public Health Reports, Washington D. C., 1921, 36: 1731-1753.
  • E. Francis:
    Tularemia. VI. Cultivation of Bacterium tularense on mediums new to this organism.
    Public Health Reports, 1922, 37: 102-115.
  • G. C. Lake, E. Francis:
    Six cases of tularemia occurring in laboratory workers.
    Public Health Reports, 1922, 37:392-413. E. Francis:
    Tularemia. Journal of the American Medical Association, 1925, 84: 1243-1250.
  • E. Francis, Alice Catherine Evans (1881-1975):
    Agglutination, cross-agglutination, and agglutinin absorption in tularemia.
    Public Health Reports, 1926, 41: 1273-1295.
  • E. Francis, George Russel Callender (1884-1973):
    Tularemia: The microscopic changes of the lesions in man.
    Archives of Pathology and Laboratory Medicine, 1927, 3:577-607.
  • H. Ohara:
    Human inoculation experiment with desease of wild rabbits, with a bacteriological study.
    Kinsey Igaku. 1925, p 12, 10.
  • H. Ohara:
    Über Identität von «Yato-Byo» (Ohara’s Disease) und «Tularämie», sowie ihren Erreger.
    Zentralblatt für Bakteriologie, Parasitenkunde und Infektionskrankheiten. Erste Abteilung, 1930, V. 117: 440-450.
  • H. Ohara:
    Ueber Identität von "Yato-Byo" (Ohara's disease und "Tularämie", sowie ihren Erreger.
    Zentralblatt für Bakteriologie, Parasitenkunde und Infektionskrankheiten. Erste Abteilung. Medizinisch-hygienische Bakteriologie und tierische Parasitenkunde. Originale. 1930, 117: 440-450. H. Ohara:
    Studies on yato-byo (Ohara's disease, tularemia in Japan).
    The Japanese Journal of Experimental Medicine, Tokyo, 1954, 24: 69-79.
    The Japanese Journal of Experimental Medicine, Tokyo, 1955: 25: 7014.

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