Tularemia cases rise sharply in Lithuania, with risks extending beyond ticks

Tularemia cases have risen sharply in both Lithuania and neighboring Latvia, but health officials caution against blaming the increase on ticks alone. The acute zoonotic disease can reach people through several routes, and its symptoms depend on how the pathogen enters the body.

Latvia has identified 17 cases this year, the country’s highest recorded total in the past decade. From 2015 to 2024, Latvia registered only seven cases in total, although the disease was confirmed in 11 people last year.

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It would be very difficult to link it to something, because there are many different ways to contract tularemia.

Lithuania has also seen a marked increase. The country recorded 41 cases between 2010 and 2021, when infections generally appeared only sporadically. The number rose to 15 in 2022, 25 in 2024 and 27 last year. No deaths from the disease were registered in Lithuania between 2021 and 2025.

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We cannot state it in the same way as with tick-borne encephalitis or Lyme disease, when the disease mainly spreads through a tick bite.

Milda Žygutienė, a chief specialist in the National Public Health Center’s communicable disease management division, told Delfi that men contract the disease two to three times more often, especially hunters and fishermen. She said infection can involve ticks, other blood-feeding insects, rodents and other animals, particularly during the processing of hunted game.

Žygutienė said increases have also been recorded in other countries, including Scandinavia. She said it would be difficult to link the rise to one factor because tularemia has many transmission routes. Greater awareness of the disease and improved diagnosis may also play a role. She rejected a direct comparison with tick-borne encephalitis, whose principal carrier is much clearer, because tularemia does not spread through ticks alone.

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The common feature between these diseases is only that they are zoonoses and that an animal participates in both their spread and the incidence of illness.