Other possible complications include: Inflammation of the lungs (pneumonia). Pneumonia can cause respiratory failure - a condition in which the lungs do not get enough oxygen, releasing carbon dioxide or both enough. Infection around the brain and spinal cord (meningitis) may occur. Meningitis is a serious and sometimes fatal infection of the fluid and membranes (meningis) surrounding the brain and spinal cord. Signs and symptoms of bacterial meningitis include high fever, severe headache, stiff neck and sensitivity to light. If it is not treated promptly; bacterial meningitis can cause brain damage and even death. Irritation around the heart (pericarditis) is also another symptom of this disease. This is swelling and irritation of the pericardium, the thin membrane that surrounds the heart. Benign pericarditis often improves without treatment, but more severe cases may require antibiotic treatment. The bone infection (osteomyelitis) is another complication. Tularemia bacteria sometimes spread to the bone, leading to pain, limited range of motion in the joints close, and sometimes skin redness, tenderness or open sores in the affected areas. Attempts to develop a vaccine tularemia have failed so far.
If you work in a high-risk occupation or live in an area where tularemia is present, these measures can help reduce the risk of infection: Protect yourself against insects. Most people get infected when tularemia tick bites. If you spend time in tick-infested areas, wear long-sleeved shirts and long pants, tuck your pants into your socks and use a wide-brimmed hat to protect your face and neck. Even bundled up, you will need to check your skin and clothing often for ticks. Use an insect repellent, but follow manufacturer's instructions carefully. Products containing DEET are still considered the most effective against ticks, although oil of lemon eucalyptus or natural insecticides may offer some protection. Use the lowest concentration of repellent in the circumstances, apply sparingly, and wash at the end of the day. Do not use DEET on infants under 2 months. Check yourself often for ticks and remove immediately if you find one.
Take care when gardening. Gardeners and landscapers should consider wearing a mask when excavation of soil, weeds or brush clearing or mowing lawns. Handle animals carefully. If you hunt or handle wild rabbits or hares, wear gloves and goggles, and wash your hands thoroughly with soap and hot water after touching animals. Cook all game meat thoroughly and avoid skinning or dressing any animal seemed ill. Protect your pets. Livestock and pets can contract tularemia if they eat part of a sick rabbit or are bitten by an infected tick. To help keep your pets safe, do not leave it unattended outside them, to provide protection against fleas and ticks, and do not let them come into close contact with wild animals or dead.