Tularemia in Suffolk: My first-hand account of the rare disease known as ‘rabbit fever’

With tularemia in the news this week — regional media outlets have reported three probable cases in Suffolk County so far this year — it seems like a good time to tell the fuller story of our own experience with this rare disease last year. 

I touched on it in a column published on Thanksgiving Day: An attitude of gratitude: a Thanksgiving reflection (Nov. 27, 2025)

Tularemia, also known as “rabbit fever,” is a rare but serious infectious disease caused by the bacterium Francisella tularensis. It can infect animals and people. Rabbits, hares and rodents are especially susceptible, and people can become infected through tick or deer fly bites, contact with sick or dead animals, contaminated water or food, or inhaling contaminated dust.

My husband, Peter, became gravely ill with tularemia after disposing of a dead rabbit he found in our yard last July. He developed sepsis and damn near died — a fate he escaped because of astute doctors, fast action, modern medicine and, frankly, a wife whose mind is wired to connect dots.

Peter blamed our indoor/outdoor cat for the dead rabbit. He saw no obvious evidence that the rabbit had met a violent end, but Cleo was known to hunt. She was born feral and, though rescued as a kitten, remained wild at heart. She came indoors on her own terms and in her own time.

About a week before Peter fell ill, Cleo suddenly became very sick. We took her to the vet, who found she had a very high fever and an infection. After 36 hours on IV antibiotics in the veterinary hospital, she was sent home. There was nothing more that could be done for her, the doctor said. He was puzzled that the antibiotics had no effect and did not hold out much hope. She died the following day.

That weekend, Peter started feeling sick. On Sunday, while we had a friend over for dinner, he had to lie down. He had a fever, a headache and swollen lymph nodes. He took Tylenol. The fever did not budge. By Monday afternoon, it was over 102.

We went to GoHealth Urgent Care in Riverhead. Even knowing how sick Peter felt, we were shocked when the doctor said he had to go to the hospital immediately. Peter had sepsis, he said, meaning an infection was spreading through his bloodstream. His fever was 103. His blood pressure and heart rate were dangerously high, though he had no history of hypertension or elevated heart rate. His white blood cell count was off the charts.

“I want to call an ambulance,” the doctor said.

In the emergency room at Peconic Bay Medical Center, doctors and staff moved quickly to test and treat him. He was immediately given IV fluids and broad-spectrum antibiotics. They drew blood and tested for a multitude of things, including tick-borne diseases Long Islanders know all too well.

Hours later, preliminary results started coming back negative. Peter was not meaningfully improving. We were waiting for the infectious disease doctor on call to arrive.

I sat beside his gurney, my mind racing. Our cat had just died after suddenly developing a high fever and an unidentified infection. Only a few days had passed between the onset of her illness and her death.

Now Peter was in the ER with a sudden illness and some of the same serious symptoms.

This could not be a coincidence.

Then I remembered the rabbit.

The infectious disease doctor arrived just as it all clicked into place in my head. I started talking immediately, sure he would think I sounded crazy. It felt crazy even as I told him about the cat and the rabbit.

He did not laugh. He looked very serious. He ordered more bloodwork and an immediate change in antibiotics.

That was when I first heard of tularemia.

Tula-what? I asked.

“It’s called rabbit fever,” the doctor explained. It is extremely rare. It is something physicians learn about in medical school but almost never see. He had seen only one case himself in decades of practicing medicine.

They would test Peter for it, he said. In the meantime, they would treat him as if that was what he had.

Peter was given two powerful antibiotics at once. One was the medication he had already been receiving. The other was one that would be used for tularemia. If that was what he had, the doctor said, he should slowly begin to recover.

Sure enough, by mid-morning, Peter showed signs of improvement. He was admitted and spent the next several days in the hospital. The infectious disease doctor was convinced of the diagnosis, though confirmation from a state lab upstate would take about a month. He was discharged with oral forms of both antibiotics for two weeks and orders to follow up with a cardiologist for management of the heart rate issue manifested with the disease. He continued to have extreme fatigue and malaise for at least a month after discharge. He is still under the cardiologist’s care and still suffers from fatigue. Rabbit fever sounds whimsical — cue the Elmer Fudd jokes — but it’s no laughing matter.

In the hospital, Peter became a patient celebrity, of sorts. Word spread, and doctors stopped by just to meet the person with tularemia. None of them had ever seen a patient with the disease.

From 1993 to 2023, New York health officials received reports of 30 tularemia cases outside New York City. Thirteen of them — about 43% — were in Suffolk County, according to state health department data published by the CDC. Suffolk recorded four cases in 2024.

When I heard the other day about a child in Riverhead infected with tularemia, it sent a chill down my spine. It occurred to me, for the first time, that I should have written about this in more detail last year, in the hope of alerting people to the symptoms and the risks.

That is especially true because, as I have since learned, tularemia can be transmitted by ticks. When we were dealing with Peter’s illness last year, the doctors told us tick transmission was possible but unusual. More typically, infection came from contact with an infected rabbit or rodent.

Some ticks can transmit the bacteria to humans, including the American dog tick, Rocky Mountain wood tick and lone star tick, according to the Centers for Disease Control and Prevention. The ticks that transmit Lyme disease are not the same ticks that transmit tularemia. The disease does not spread from person to person.

Cats can also get sick with tularemia. Transmission from pets to people appears uncommon, but people should avoid direct contact with sick or dead animals and use gloves or other protection if handling an animal is unavoidable.

The CDC says tularemia symptoms vary depending on how the bacteria enter the body. The illness can range from mild to life-threatening, but fever is present in all forms and can be high. Other symptoms may include chills, headache, fatigue, muscle aches, sore throat, cough, vomiting, diarrhea, abdominal pain, swollen lymph nodes and, in some cases, a skin ulcer at the site where the bacteria entered the body.

Learn more about tularemia transmission and symptoms on the CDC website:
https://www.cdc.gov/tularemia/about/

As we learned last year, this infection can escalate rapidly into a life-threatening illness. We should all know what to watch for — especially after a tick bite, a deer fly bite or contact with a sick or dead animal.

Given the proliferation of ticks where we live, it would not be surprising if we see more cases of this disease in the future. It was not so long ago that other tick-borne illnesses now commonplace on Long Island were rarely encountered.