Tularaemia is primarily a disease of a wide variety of wild mammals and birds caused by Francisella tularensis. It circulates in populations of rodents and lagomorphs, and outbreaks in humans (zoonotic infection) often parallel outbreaks in animal populations. Humans become infected mainly through the bite of arthropods, and through the skin, conjunctival sac or oropharyngeal mucosa, by direct contact with infected animals and by ingestion of contaminated food or water or inhalation of contaminated dust or aerosols. The type and severity of the human disease is dependent on strain, dose and route of infection. Infection through the skin results in ulceroglandular tularaemia and inhalation of F. tularensis results in respiratory or pneumonic tularaemia.