The recent death of a Martha’s Vineyard seasonal resident with an apparent case of tularemia has sparked renewed discussion on the Island about the ongoing need for public education around tick-borne illnesses.

Maria Danielson told the Gazette in an email that her father Davio Danielson died last week at Cooley Dickinson Hospital in Northampton, and that tularemia was confirmed as the cause. Mr. Danielson fell ill after he had been cutting brush on his Oak Bluffs property, his daughter said. He did not seek medical treatment on the Island and went back to western Massachusetts, where he sought treatment when his symptoms grew worse, she said.

Tularemia is a tick-borne illness that can be transmitted by a tick bite and also from infected dead animals, causing a pneumonia-like illness that can be fatal.

Spokesmen for the state Department of Public Health and Cooley Dickinson said this week that they could not confirm or comment on the case, citing laws that protect patient confidentiality.

Public health officials on the Vineyard said the recent case should not be cause for alarm but rather an opportunity to raise awareness about prevention, diagnosis and early treatment, especially as tick-borne illnesses become more prevalent.

“This case should not be looked at as Armageddon,” said Dr. Sam Telford, professor of infectious diseases and global health at Tufts University who has extensively studied tick-borne illnesses and is widely considered the top expert on the Vineyard.

He said Island medical practitioners have become expert by now at diagnosis.

“It is well entrenched on Martha’s Vineyard and no longer a surprise,” he said. “The people at the hospital are well versed in this — they can smell tularemia when it comes in the door.”

Dr. Telford said between three and 15 cases of tularemia have been documented on the Vineyard every year going back to 1999.

“It is a little late in the season — typically we see tularemia cases early in the summer,” he added.

According to data tracked by Island Health Care in Edgartown, which contracts with Island towns for public health services, in 2017 there were six reported cases of tularemia. So far this year four cases have been reported, according to Lila Fischer, a public health nurse with the agency.

Health care providers in Massachusetts are required to report suspected and confirmed cases of tularemia immediately to the Department of Public Health, which also directs them to send isolates to the state public health laboratory for analysis. Isolates are samples of bacteria isolated from a specimen.

Nationwide, tularemia is a relatively rare disease, according to the Centers for Disease Control, which has tracked its incidence since 1950. Between 2006 and 2016, there were an average of 172 reported cases per year across the country, with the highest incidence in Arkansas, Kansas, Missouri and Oklahoma where there are 25 to 35 cases per year in each state.

In New England, tularemia is extremely rare apart from Martha’s Vineyard, which state statistics show reached a high of 16 confirmed and probable cases in 2008. The majority of cases, according to the state DPH, have been people who work outdoors, especially landscapers.

Tularemia can be contracted in one of several ways. The disease is carried by certain ticks including the common dog tick (also called the wood tick). A person can also become infected after touching, handling, eating or being bitten by an infected animal, or having contact with water or soil that has been contaminated by an infected animal. The most serious form is pneumonic tularemia, which usually results from breathing dusts or aerosols containing the organism. Between 2000 and 2010, more than 40 people on Martha’s Vineyard were diagnosed with the pneumonic variety, according to a Department of Public Health update issued in May 2010.

The last known death from tularemia on Martha’s Vineyard was in 2000, when a 43-year-old landscaper from Chilmark contracted the pneumonic form and failed to seek medical attention in time. Investigators suspected that David Kurth may have inhaled the remains or feces of an infected rodent while mowing a lawn near Squibnocket.

Symptoms may include fever, swollen glands, body aches, coughing and chest pains. In the case of tularemia caused by a tick bite, the area of entry may be inflamed and sore. Symptoms usually occur within three to five days of exposure, but can take as long as 21 days to show up. Early treatment with antibiotics usually cures the disease in a few days. The disease is confirmed with a blood test and cultures.

Public health officials recommend that people who work outdoors check for dead animals before using any lawn mowing or brush cutting equipment, avoid touching dead animals with bare hands and use a dust mask.

And anyone who spends time outdoors is reminded to take precautions against tick bites, including wearing long, light colored pants tucked into socks or boots and using insect repellent and permethrin-treated clothing, and checking their body for ticks after possible exposure. Anyone who has symptoms is urged to seek early treatment, and if off Island advise health care providers of the risks.

Dr. Telford praised the work of the tick-borne illness prevention program led by Island biologist Dick Johnson, and the educational website developed by the Island boards of health.

“There’s plenty of stuff to be worried about on Martha’s Vineyard,” he said. “Tularemia is not something that should cause people to become hysterical... we need to protect against tick bites, this patient was doing yard work so that’s a signal.

“It all boils down to the fact that ticks are keeping these infections around in nature and we need to something about it.”