Fourth Case of Rare "Rabbit Fever" Confirmed in New York County
A fourth case of tularemia, a rare bacterial illness commonly known as "rabbit fever," has been confirmed in Suffolk County, New York, as health officials track an unusual cluster in the Long Island community this year.
Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, confirmed the latest case to ABC News in a statement Thursday. Tularemia is caused by the bacterium Francisella tularensis and can spread to humans through tick and deer fly bites, contact with infected animals such as rabbits and rodents, or, less commonly, through contaminated water, soil, dust or undercooked rabbit meat, according to the New York State Department of Health. Importantly, the illness does not spread from person to person.
A Small but Notable Cluster
While tularemia remains rare, Suffolk County has recorded cases every year since 2023: three that year, four in 2024, and six in 2025, according to Pigott. Nationally, the CDC estimates only about 200 to 300 cases are reported annually across the entire country, making Suffolk County's recurring cluster somewhat unusual for a single county.
Health officials identified a tick bite as the source of one of this year's four local infections but haven't disclosed how the other patients were exposed. According to Newsday, the fourth case involved a Riverhead woman being treated after a cat bite, though that detail hasn't been independently confirmed by county health officials or the hospital involved.
Why the Disease Is Easy to Miss
Dr. Bruce Hirsch, an infectious disease specialist, said tularemia's rarity makes it a notoriously difficult diagnosis for doctors to catch. "Rabbit fever is really unusual. I've been in infectious disease for a long period of time, and I see this diagnosis regularly on board examinations, not in the real world," Hirsch said. He added that while the illness is highly treatable with antibiotics, patients can remain sick for extended periods unless a physician thinks to test for it specifically.
That pattern played out in one Suffolk County family's experience this spring. Tracey Detmer told Patch that her 9-year-old son, John, developed a swollen lymph node and severe neck pain after finding a tick on his head in April. His symptoms, including a fever that lasted roughly 11 days, dragged on for weeks before doctors made the connection to tularemia.
Symptoms and Prevention
Symptoms typically appear three to five days after exposure, though they can take up to three weeks to show up, and vary depending on how a person was infected. Common signs include high fever, sometimes reaching up to 104 degrees, skin ulcers, and swollen lymph nodes. The most serious form, pneumonic tularemia, develops when a person breathes in infected dust or aerosols, or when the bacteria spreads to the lungs through the bloodstream, and can cause cough, chest pain and difficulty breathing.
Health experts recommend wearing long pants outdoors, using insect repellent containing DEET, and checking for ticks after spending time outside. Pets are also at risk, so keeping cats and dogs on tick and flea preventatives is advised as well.
The recent cluster comes amid a broader spike in tick activity, with emergency room visits for tick bites nationwide reaching their highest level in nearly a decade this year, with the Northeast and Midwest hit hardest.
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