How is tularemia primarily transmitted to humans?

Tularemia is primarily transmitted to humans through direct contact with infected animals, particularly when handling rodents and rabbits. The causative agent of tularemia, Francisella tularensis, can enter the body through skin cuts or abrasions, or through mucous membranes when individuals come into contact with the body fluids, tissues, or even when cleaning the carcasses of infected animals. This route of transmission is significant, as hunting or trapping these animals often implicates humans in the risk of acquiring the disease.

In contrast, while other routes of transmission such as contaminated water, insect bites, and consumption of undercooked meat may play a role in the spread of various zoonotic diseases, they are not the primary means by which tularemia is contracted. The emphasis on handling infected forest animals underscores the importance of awareness and caution for those who work or recreate in environments where these animals are present.