Q Fever: Overview for Health Care
Providers
One page summary of: Organism, Infective dose, Occurrence, Natural reservoir,
Route of Infection, Risk Factors
Q Fever:
Guidance for Health Care Providers
Key Medical and Public Health Interventions After Identification
of a Suspected Case
What is Q fever?
Q fever is a disease caused by the bacterium Coxiella burnetii.
The disease can occur in two forms: acute (shortterm)
and chronic (long-term). Q fever has been reported from most parts
of the world. However, this disease is
rare in the U.S. For example, only four cases were reported in Virginia
from 1987-2003.
Sheep, cattle and goats sometimes carry C. burnetii. It may rarely
be carried by cats, dogs, rabbits, birds, rodents
and ticks. The organism can also survive for long periods in the
environment (e.g., in dust, wool, straw, fertilizer).
Who gets Q fever?
Anyone can get Q fever. However, people with frequent animal exposures
(such as veterinarians, researchers, meat
workers, and sheep and dairy farmers) are at the most risk.
How could a person be infected with Q fever?
Q fever is very rarely spread from person-to-person. The most common
way of becoming infected is by breathing
in dust contaminated by the birth fluids, urine or feces (stool)
of infected animals. Direct contact with
contaminated materials, such as wool, straw or fertilizer has also
been associated with Q fever. In addition, Q fever
may very rarely be caused by breathing in C. burnetii carried by
the wind, by drinking raw milk from infected cows
or by receiving blood or bone marrow transfusions from infected
people.
Could Q fever be used for bioterrorism?
Yes. C. burnetii is one of the agents that could be used for bioterrorism
because it is highly infectious, it is easy to
obtain, and it would be easy to spread. Release of Q fever as a
bioterrorism agent would likely be in the form of an
aerosol.
What are the symptoms of Q fever?
About half of the people who get Q fever do not have any symptoms.
People who develop acute Q fever may have
a sudden onset of fever (up to 105° F), severe headache, muscle
aches and a general feeling of illness. Fever
usually lasts for one to two weeks, but may last as long as two
months. More severe illness may include pneumonia
or inflammation of the liver (hepatitis), heart (myocarditis/pericarditis)
or brain (meningitis/encephalitis). Infection
during pregnancy can cause miscarriage.
A small percentage of people infected with C. burnetii develop chronic
Q fever. This most often involves infection
of the heart valves, but can appear as hepatitis, bone infections
(osteomyelitis) or chronic fatigue.
How soon after exposure do symptoms appear?
The symptoms of acute Q fever generally appear about two to three
weeks after exposure. Chronic Q fever may
occur months to years after exposure.
How is Q fever diagnosed and treated?
Q fever is diagnosed through special laboratory blood tests. Specific
antibiotics can be prescribed by a doctor to
treat Q fever. To be effective, treatment should start immediately
and continue for several weeks. Chronic Q fever
may require years of treatment with antibiotics and possibly heart
valve replacement.
What can be done to prevent the spread of Q fever?
Avoid sources of infection and properly disinfect and dispose of
animal materials such as hides, bedding, etc.
People operating cow and sheep sheds, barns and laboratories that
use such animals should restrict access to these
facilities and use precautions. Milk from cows, goats and sheep
should be consumed only if pasteurized. A Q fever
vaccine is not available for use by the general public. No isolation
or exclusion is necessary for persons with Q
fever.
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