March 20, 2025, 9:40 pm | Read time: 5 minutes

Tularemia, often referred to as rabbit fever, is currently on the rise. Two cases of the highly contagious tularemia have been confirmed in the district of Giessen. The issue is that this bacterial disease can affect not only wild animals but can also be transmitted to humans. Authorities warn against contact with infected animals.

What is Rabbit Fever?

Tularemia, also known as rabbit fever, is an infectious disease caused by the bacterium Francisella tularensis. The pathogen is usually found in wild animals and is particularly common in rodents, hares, and wild rabbits.

Tularemia is currently spreading in Lower Saxony. Two cases have now also been confirmed in Hesse. As the Hessian Ministry of the Environment and the Hessian State Laboratory announced on Tuesday, two infected hares were discovered in Hungen and Linden (district of Giessen) in January. Cases have also been reported in Rhineland-Palatinate, Baden-Württemberg and Saarland.

Unlike many other animal diseases, rabbit plague can also be transmitted to humans — as it is a zoonosis. The term “zoonosis” comes from the Greek and is made up of “zoon” (living being) and “nosos” (disease). Zoonoses refer to infectious diseases that are caused by bacteria, viruses, parasites, fungi, or prions and can be transmitted from animals to humans and vice versa.¹

The Ministry of the Environment, therefore, urgently warns against touching hares, wild rabbits, and rodents such as mice, rats, and squirrels.

Occurrence

The bacterium occurs worldwide, mainly in the northern hemisphere. While the more dangerous subspecies “Francisella tularensis ssp. tularensis” is widespread in North America, the less aggressive variant “Francisella tularensis ssp. holarctica” is mainly found in Europe.

In addition, the pathogen is highly resistant: it can survive in the environment — in soil, water, or mud — for weeks to months. Due to the special composition of its cell wall, it is extremely resistant to external influences.²

Causes and Transmission Routes

Infection with the pathogen can occur in various ways:

• Direct contact: Infection through contact with infected animals or their carcasses.
• Consumption of contaminated food: Especially through undercooked meat or contaminated water.
• Inhalation of pathogens: Infection via dust particles or droplets, for example, during agricultural work.
• Bites or stings from infected insects: Ticks and other blood-sucking parasites can pass on the pathogen.

What is dangerous is that even a minimal amount of bacteria can be enough to trigger an infection.³

Symptoms of Tularemia

In Humans

The course of the disease can vary depending on the route of infection. As a rule, flu-like symptoms occur in humans:

• Headache and aching limbs
• High fever
• Swollen lymph nodes
• Nausea, diarrhea, or vomiting

In addition, infection via skin lesions can lead to poorly healing ulcers. In severe cases, pneumonia or blood poisoning can occur.

In Animals

Infected hares have a high mortality rate. Infected animals lose a lot of weight, walk unsteadily, or appear apathetic. In addition, they often lose their natural shyness towards humans, which increases the risk of unwanted contact. They usually die of sepsis within two to 13 days. There is only a low risk for hunting dogs — they usually remain symptom-free or only develop mild symptoms such as loss of appetite, fever, and swollen lymph nodes. Although infection usually requires intensive contact with infected or dead animals and their excrement, caution is still advised.

Current Cases in Hesse

Apart from the two confirmed cases in Hungen and Linden, an increasing number of tularaemia infections have been detected across Germany in recent months. In Hesse, there have been a total of ten reported cases since 2023, including in the districts of Main-Kinzig, Limburg-Weilburg, Rheingau-Taunus, Werra-Meißner and Wiesbaden.⁴

Particularly at Risk Are

In Europe, it is primarily the Scandinavian countries that are more affected by tularemia. In Germany, the first documented cases in humans date back to 1931. While there were still 100 to 200 infections per year in the 1940s, the number fell to less than ten cases per year in the early 2000s. However, a continuous increase has been observed since 2013. Around 70 infections were reported annually until 2019. After 59 cases in 2020, the number rose to 119 in 2021, fell again to 72 in 2022, and finally reached 92 reported cases in 2023.

A tularaemia outbreak in Hesse in 2005, which affected several participants in a driven hunt, attracted particular attention. After skinning and dismembering the hunted animals, some of the hunters developed symptoms such as chills, headaches, aching limbs, fever, and swollen lymph nodes within a few days. Seven people became seriously ill, and the infection was fatal for one hunter.⁵

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Protective Measures and Prevention

Due to the fact that there are currently no proper measures to combat rabbit plague, the following measures are particularly important:

• No direct contact: You should not have direct contact with wild animals or carcasses
• Keep pets away: Dogs and cats should have no contact with wild animals.
• Cook meat thoroughly: Hare meat should only be eaten well-cooked.
• Use protective clothing: Hunters, foresters, and forest workers should wear gloves and use an FFP2 or FFP3 mask.

As the number of tularaemia cases in Germany has increased in recent years, experts advise consistent compliance with protective measures.