While adorable, rabbits could be in part to blame for a tularemia epidemic in four states, including Colorado, Nebraska, South Dakota, and Wyoming. The Centers for Disease Control and Prevention (CDC) recently released a report, published in the Morbidity and Mortality Weekly Report, warning of the rise of infections in the Midwest.

Tularemia, also known as rabbit fever, is a relatively rare bacterial disease, with only about 125 reported cases per year over the last two decades. But since September 2015, 100 cases have been reported.

Colorado has had the most cases, at 43. An 85-year-old Colorado man died, and many others have been hospitalized. While the cause of the rise in cases is still being investigated, the CDC believes an increase in the rabbit population and in awareness of the disease among health care professionals may have contributed to it.

Here's what you need to know about this disease.

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What is tularemia?

Tularemia is a disease caused by the bacterium Francisella tularensis. It can enter the body through the skin, eyes, mouth or lungs. A person can become infected through the bite of an infected tick or deerfly, by handling infected animals such as rabbits, by consuming contaminated food or by inhaling airborne bacteria, according to the CDC. Most cases occur in rural areas. The disease has been reported in all U.S. states except for Hawaii.

While the bacteria can spread from animals to humans, it can't spread from human to human.

The disease can be treated with antibiotics, but it can be life-threatening depending on the type of strain, according to the CDC.

Symptoms

Symptoms may vary depending on how the person was exposed to the bacteria. For example, someone who touched an infected animal might develop skin ulcers and swollen lymph nodes. A person who mowed over a dead animal infected with the bacteria, and breathed in contaminated air, might experience trouble breathing. The incubation period is between three and five days after exposure.

Other possible symptoms include mouth ulcers, chest pain, fever, muscle or joint pain, pink eye and stomach pain with vomiting and diarrhea.

Diagnosis

"Rabbit fever" is diagnosed with the help of cultures and blood samples. It's a difficult disease to diagnose because its symptoms can mimic those of more common infections, so the CDC advises the affected person to share all possible exposures, such as any bites or contact with animals, with their doctor. Treatment usually lasts 10 to 21 days depending on the stage of illness and the antibiotic used.

According to the CDC, most people make a full recovery.

Related: The Animals Most Dangerous to Humans

How to protect yourself

The CDC recommends residents in affected states take the following precautions to prevent exposure to the bacteria:

  • Avoid handling animals without gloves as they may be carriers, especially rabbits, muskrats, prairie dogs and other rodents.
  • Use insect repellent at all times.
  • Wear long pants and long sleeves to keep ticks and deer flies off your skin.
  • Wear a mask when doing yard work, and don't mow near or over dead animals.
  • When hiking, don’t drink untreated surface water.

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Muriel Vega is a writer with a passion for budget travel and staying safe while abroad. A Georgia State University graduate, she has over 6 years of editorial experience and has written for The Guardian, The Atlantic, The Billfold, among other outlets. In her free time, you can find her baking pies, playing with her two dogs and cat, or planning her next vacation. She spends way too much time on Twitter, one of her favorite social media channels. Her favorite safety tip: Make sure you have all the necessary shots before you go abroad.