López C E, Kornblatt A N, Sikes R K, Hanes O E
South Med J. 1982 Apr;75(4):405-7.
In the period 1960 to 1979, 177 cases of tularemia occurred in residents of Georgia. A tick bite was the implicated source of exposure in eight cases (4.5%), whereas 91 cases (51.4%) were associated with direct contact with infected rabbits. In Georgia and other southeastern states, the epidemiology of human tularemia infection primarily involves rabbits. However, a diagnosis of tularemia should still be considered in this region in a febrile patient with or without a primary lesion or reported exposure to rabbits. A history of having been bitten by a tick may be the major clue in determining the diagnosis. A primary ulcerative lesion on the legs or in concealed body areas such as the axillary or intergluteal regions, is commonly the presenting sign in the patient with tick-borne tularemia.
1960年至1979年期间，佐治亚州居民中发生了177例兔热病病例。8例（4.5%）的感染源为蜱叮咬，而91例（51.4%）与直接接触受感染的兔子有关。在佐治亚州和其他东南部各州，人类兔热病感染的流行病学主要涉及兔子。然而，在该地区，无论是否有原发性皮损或报告有接触兔子史的发热患者，仍应考虑兔热病的诊断。蜱叮咬史可能是确诊的主要线索。腿部或腋窝、臀间等隐蔽身体部位出现原发性溃疡性皮损，通常是蜱传兔热病患者的首发症状。
