Tularemia on Martha's Vineyard

Via ProMED-mail: the Vineyard Gazette reports an unusual case of oropharyngeal tularemia contracted by a landscaper on Martha's Vineyard who handled a dead rabbit.

Tularemia is a powerful but rare bacterial disease. Rabbits are the most common carriers in addition to rodents such as squirrels, voles and muskrats, but a bite from a dog tick is the most typical way the disease is transmitted to people.
On the Vineyard, though, the pneumonic cases have dominated, making the Island the only place in the United States to experience an outbreak of pneumonic tularemia.