Tularemia occurs throughout the U.S. and is transmitted to humans by the American dog tick (Dermacentor variabilis), the wood tick (Dermacentor andersoni), lone star tick (Amblyomma americanum) and, in the western U.S., by deer flies. Humans can also contract the disease through skin contact with infected animals, ingestion of contaminated water and inhalation of contaminated dusts.
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