Martha's Vineyard-Four "landscapers or people who work outdoors" have possibly contracted a rare bacterial infection (tularemia). Tularemia killed one man three years ago on the island. Since 2000, 22 cases of tularemia (mostly pneumonic) have been confirmed on the island; 18 of the cases were landscapers or people who worked primarily outdoors. Tularemia can be contracted from infected animals (more often rodents, rabbits, and hares); people can also get infected from tick or deerfly bites (that have fed on the infected arthropods), by contaminated food and water, or inhaling the airborne bacteria. Why so many cases of tularemia are showing up on the Vineyard is unknown. New York state averages only two such cases a year, and no other state has experienced an outbreak. The Centers for Disease Control in Atlanta has been monitoring the outbreak since 2000, but has found only several isolated incidences of infected animal life on the island. One hypothesis is that the bacteria is in the dirt or grass, and when the ground is worked by the landscapers, it becomes airborne and is inhaled. Landscapers on the island are being advised to wear dust masks when they work. Sources 1. Vineyard Gazette, July 22. 2. Centers for Disease Control and Prevention, Atlanta.