Cipro headed. Do not drive or use machinery (ciprofloxacin) until you know how it will affect you. You are taking the antibiotic ciprofloxacin (“cipro”) to treat possible Seek medical attention at once if exposure to tularemia. you have any of these signs of an allergic reaction to cipro Begin taking this medicine soon after leaving the medication center.  Skin rash or hives  Wheezing or trouble breathing Follow directions  Swelling of the face, lips or throat  Severe diarrhea  Take all of your medicine as  Seizures prescribed even if you feel well.  Take this medicine with a full glass of Tell a health care professional if you water. Drink several glasses each day have: nausea, mild diarrhea, joint pain, while you are taking this medicine. stomach pain, dizziness or headache.  If it upsets your stomach, take it with 24-Hour food (but not milk, yogurt, or cheese). Watch for signs of tularemia Information  If you miss a dose: Go to a hospital now if you have: o Take the missed dose as soon as Sores on skin Body ache Chills possible. Headache Weakness If it is almost time for your next Hotline: o Chest pain Difficulty breathing 206-296-1500 dose, skip the missed dose and take your next dose on schedule. Lymph node swelling Fever o Do not take two doses at the same time. Drugs and food to avoid TTY Relay:

711 Warning Do not take these drugs within two hours of taking cipro: antacids (Tums If you are pregnant, might be pregnant, or Maalox, iron or zinc supplements, Web sites: are breastfeeding or have epilepsy or vitamins, or sucralfate (Carafate), You [ LHJ WEB SITE ] kidney disease, tell health care workers may take them two hours after or six before taking this medicine. hours before cipro. If you take asthma www.doh.wa.gov medicine like theophylline or a blood Do not take this medicine if you have thinner like Coumadin, tell your health had an allergic reaction to ciprofloxacin care professional. or other quinolone medicines such as Do not drink more than two caffeinated norfloxacin (Noroxin), ofloxacin (Floxin), beverages (coffee, tea, soft drinks) per levofloxicin (Levaquin) or gatifloxacin day. Do not take Cipro with foods ((Tequin). containing large amounts of calcium (milk, yogurt, cheese). This medicine increases the chance of sunburn; use sunscreen. You may need more medicine Cipro may make you dizzy or light- Check radio, television, a newspaper or About tularemia the Internet to find out if you need an additional supply and where to get it. About tularemia Tularemia is an infectious disease of animals and lymph glands in the neck and inflammation of humans caused by the bacteria Francisella the throat. tularensis. Most human cases are caused by bites o Handling contaminated materials causes from infected ticks and the handling of infected swollen lymph glands, and less often, skin rabbits. ulcers.

An act of bioterrorism might include the intentional All forms of the disease are accompanied by flu-like release of tularemia into the air. symptoms, such as fever, chills, headaches, body Tularemia cannot be spread aches, and weakness that usually occur three to five from person to person. days after exposure to the bacteria. A person with pneumonia can develop chest pain, How is tularemia spread? difficulty breathing and respiratory failure. You can get tularemia by handling infected materials, by eating or drinking contaminated food If you have symptoms, please consult a healthcare or water or by inhaling contaminated dusts or provider as soon as possible. sprays. Prevention and treatment What are the symptoms? Those exposed to tularemia are often treated with Tularemia symptoms depend on the how a person is antibiotics to prevent infection. Currently there is no exposed to the bacteria: vaccine available for general use. Antibiotics should o Breathing in the bacteria causes infection of be used to prevent or treat tularemia only under the the lungs. direction your health care provider or local health o Eating contaminated food or drinking department. contaminated water causes enlargement of Early prevention and prompt treatment can save your life.

Be Smart, Take Your Medicine

Taking the medicine that has been provided to you—even if you don’t feel sick—is the best thing you can do for your health and safety right now.

 Antibiotics are effective in preventing anthrax.  Your family and friends are counting on you to stay well.

Take Care of Yourself

 Get plenty of rest.  Stay connected to family and friends for support.  Stay physically active.  Follow the instructions for taking your medicine  Eat healthy foods. Give your body what it needs.