What in the Lyme is Going on in NY: A Breakdown of Tularemia (Rabbit Disease) by Christie Korth, MS, CHC, AADP

Lyme has become a very hot topic this summer in NY, particularly on Long Island. For me personally, this strain had hit home as I know of a family who had been recently interviewed about their experience with Tularemia in Suffolk County. My purpose for writing today's article is to inform you of the background of Tularemia, it's affect on the body, its origins and most importantly- what do you do if you contract it?

Lets start with- What the heck is Tularemia?

If you live on Long Island, you're probably already familiar with the usual tick conversation: Lyme disease, Babesia, ehrlichiosis, anaplasmosis, and—more recently—alpha-gal syndrome.

But there's another tick-associated illness getting attention in New York, and its nickname alone is enough to make most people stop and ask:

Rabbit fever? What the heck is that?

Rabbit fever is the common name for tularemia, a potentially serious infection caused by the bacterium Francisella tularensis. And although tularemia remains rare, recent New York data give those of us living in Suffolk County a very good reason to understand it. Caution: Please do not fear rabbits!

Why are we talking about tularemia now?

In January 2026, researchers from the New York State Department of Health and Suffolk County Department of Health Services published a study examining reported tularemia cases in New York from 1993 through 2023.

During those 31 years, New York reported only 30 confirmed or probable cases.

But here's the part that caught my attention:

Thirteen of those 30 cases—43% of the entire state's reported cases—occurred right here in Suffolk County. Hmmmm.... What is going on?????

Half of all New York cases occurred on Long Island, and the researchers also found that cases became more concentrated in the latter portion of the study period.

Moreover, and even more interesting- Suffolk County researchers conducted tick surveillance from 2019–2023 and detected F. tularensis in a pool of locally collected lone star tick nymphs.

In other words, this isn't simply a bacterium we're reading about occurring somewhere else in the country. Researchers have documented the organism in ticks collected here in Suffolk County.

And that brings us to an important question.

What exactly is “rabbit fever”?

Tularemia is a zoonotic disease, meaning it can move between animals and humans.

Rabbits, hares and rodents are particularly susceptible to F. tularensis and may die during outbreaks, which helps explain the nickname “rabbit fever.” But you do not need to touch a rabbit—or even encounter one—to develop tularemia.

Humans can be exposed through several routes, including infected ticks, deer flies, contact with infected animals, contaminated food or water, or inhalation of contaminated aerosols or dust.

And here's where things get particularly interesting for Long Islanders.

It's not just the Lyme disease tick

When most people on Long Island hear “tick-borne illness,” they immediately think of the blacklegged—or deer—tick associated with Lyme disease.

Tularemia is different.

In the United States, ticks known to transmit F. tularensis include the:

American dog tick (Dermacentor variabilis)Rocky Mountain wood tick (Dermacentor andersoni)Lone star tick (Amblyomma americanum)

CDC specifically notes that these are not the same principal tick vectors responsible for transmitting Borrelia burgdorferi, the bacterium that causes Lyme disease.

That lone star tick deserves special attention on Long Island because we're already discussing it in connection with illnesses and conditions including ehrlichiosis and alpha-gal syndrome.

One tick bite doesn't necessarily mean one possible problem.

Wait—can you really get tularemia from mowing the lawn?

Here's one of those facts that sounds made up but isn't.

Tularemia can sometimes be acquired by inhaling contaminated aerosols or landscaping/agricultural dust. CDC specifically advises people not to mow over sick or dead animals because doing so can potentially aerosolize infectious material.

So if you encounter a dead rabbit or rodent in your yard, don't simply run the lawn mower over it.

Yes, I realize that may be advice you never expected to need.

Welcome to tick season in 2026. It's crazy town- but there are many solutions both in nutrition as well as utlizing medications. There are also preventative precautions you can take- which we will be discussing on this weeks episode of Tick Talk Tuesdays!

What does tularemia look like?

This is where tularemia becomes especially tricky.

There isn't one single presentation because symptoms can depend upon how the bacteria entered the body.

Symptoms typically begin around 3–5 days after exposure, although the reported range is 1–21 days. General symptoms can include fever, chills, headache, fatigue, muscle aches, poor appetite, sore throat, cough, chest discomfort, vomiting, diarrhea and abdominal pain.

Different forms of the illness include:

• Ulceroglandular tularemia: often an ulcer where the organism entered the skin accompanied by swollen regional lymph nodes.

• Glandular tularemia: swollen lymph nodes without the characteristic skin ulcer.

• Oculoglandular tularemia: infection involving the eye, which can cause conjunctivitis and nearby lymph-node swelling.

• Oropharyngeal tularemia: often associated with ingestion and may cause severe sore throat, tonsillitis or pharyngitis and cervical lymph-node swelling.

• Pneumonic tularemia: can occur after inhalation or spread from another infection site and may cause cough, chest pain or other pulmonary findings.

• Typhoidal tularemia: a systemic illness without the more obvious localized features of the other forms.

That variability matters because someone with tularemia may not walk into a medical office saying, “I was bitten by a tick and now I have a rash.”

There may not even be a recognized tick bite.

Testing isn't always as straightforward as you might think

Here's another important piece.

Antibodies against F. tularensis often aren't detectable until two to three weeks after symptoms begin.

That means an early negative antibody test does not necessarily exclude tularemia. When appropriate, paired blood samples taken at different points in the illness can demonstrate the development of antibodies. PCR and other testing methods may also be useful depending on the clinical situation.

There's also an unusual laboratory consideration: when tularemia is suspected, CDC recommends that the laboratory be alerted because F. tularensis requires special diagnostic and laboratory-safety considerations.

For patients, there's a simple takeaway:

Your exposure history matters.

Tell your healthcare provider about tick bites, outdoor exposures, contact with rabbits or other wildlife, and even unusual landscaping exposures.

Sometimes the seemingly insignificant detail is the detail that matters.

Is tularemia treatable?

Yes.

Tularemia can be serious—and occasionally life-threatening—but it is treatable with appropriate antibiotics. Current CDC recommendations include ciprofloxacin, levofloxacin, gentamicin and doxycycline, with the appropriate medication and treatment duration depending on factors including disease severity and the individual patient. Fortunately, there are also many interventions that an be utilized in "nutrition world".

This is one reason recognizing the disease matters.

So should Long Islanders panic about rabbit fever?

No.

Thirty reported cases across New York over 31 years is still a rare disease.

But rare doesn't mean irrelevant, particularly when nearly half of those reported New York cases came from Suffolk County and local surveillance has actually detected the causative bacterium in local ticks.

The lesson isn't to be afraid of your backyard.

The lesson is that our understanding of tick-borne and tick-associated disease needs to extend beyond Lyme.

Learn what ticks live where you live. Perform tick checks. Use appropriate prevention strategies. Pay attention to unusual symptoms after outdoor exposure. And make sure your healthcare provider knows about relevant animal, tick and environmental exposures.

Because here on Long Island, the tick conversation is getting a whole lot bigger than Lyme disease.

And that's exactly why we're talking about it.

For more information- please check out this week's episode of Tick Talk Tuesday's- Tuesday at 8pm EST LIVE on Facebook and YouTube. My amazing co-host, Jessica Semiken Wick and we look forward to continuing the discussion there! We will also be discussing Burboun Virus as well as Alpha-Gal and what you can do to help yourself or a loved one navigate these co-infections.