The greatest risk factor for contracting tularemia is the bite of an infected tick. Other risk factors include handling contact with infected animals, contamination of water sources, and potential bioterrorism. Individuals are at a higher risk of infection during the late spring and summer months. Children and males are at a higher risk of infection.

• In the United States, most persons with tularemia acquire the infection from arthropod bites, particularly tick bites, or from contact with infected mammals, particularly rabbits.
• Outbreaks of tularemia in the United States have been associated with muskrat handling, tick bites, deer-fly bites, and lawn mowing or cutting brush.
• Sporadic cases in the United States have been associated with contaminated drinking water and various laboratory exposures.
• Outbreaks of pneumonic tularemia, particularly in low-incidence areas, should prompt consideration of bioterrorism.^[1]

• In recent years, a seasonal increase in incidence has occurred only in the late spring and summer months, when arthropod bites are most common.

• Tularemia is more common among males than females.
• Tularemia occurs within populations of all ages, however is most common within children.^[2]