Q-fever Coxiella Burnetii Dr. Hani Masaadeh MD PhD
Jan 19, 2016
Q-fever
Coxiella Burnetii
Dr. Hani MasaadehMD PhD
ORGANISM Coxiella burnetii is a small pleomorphic Gram-
negative bacterium that originally was classified among the Rickettsiaceae.
C. burnetii proliferates intracellularly in an acidic vacuole (phagolysosome). The organism can survive for a long time as a spore in very unfavourable conditions.
Q fever is a zoonotic disease caused by Coxiella burnetii
Signs and Symptoms in Humans Q fever begin with sudden onset of one or
more of the following: high fevers , severe headache, general malaise, myalgia, confusion, sore throat, chills, sweats, non-productive cough, nausea, vomiting, diarrhea, abdominal pain, and chest pain.
Q-fever: Coxiella burnetii
Obligate intracellular rickettsia Highly infectious - one organism may
cause disease Found worldwide Reservoir = animals Hardy organism
Q-fever: Reservoir Species Goats, sheep and cattle:
• No obvious illness in animals
• Can cause abortions Cats Rabbits Birds Rodents ????
Q-fever: Transmission to Humans
Organism is excreted in urine, feces, milk, and especially in birth fluids
Humans are usually infected by inhalation of the organism from contaminated environments
Occasionally raw milk
Potential Sources of Infection
Contaminated wool Soiled laundry Livestock trucks Livestock Air conditioner ducts in common with
animal quarters Contaminated airborne dust particles
Q-fever
High concentrations in animal tissues, especially placenta
Survives for long periods in environment
Highly resistant to physical and chemical agents
Q-fever: Risk Factors
Direct contact with infected animals Farmers Veterinarians Slaughterhouse workers Sheep researchers
Q Fever: Human Illness
Incubation period is 20 days (14 - 39 days)
Symptoms may include headache, weakness, malaise, chills, severe sweats, retro-orbital pain
Pneumonia Abnormal liver function tests Granulomatous hepatitis
Q Fever: Human Illness
Self-limited febrile illness of 2-14 days Chronic Q fever
• endocarditis results in less than 1% of Q fever cases
• Endocarditis may develop in 1 to several years after infection
Osteomyelitis and/or neurologic manifestations are also possible
TREATMENT The aim of treatment is different in acute and
chronic Q fever. In acute infection, bacteriostatic treatment will
usually suffice for a clinical cure. Doxycycline is a good choice here .
In chronic Q fever treatment with doxycycline, ciprofloxacin and rifampicin should preferably be given for a long period (1-3 years).
Preventive Measures
Education of high risk individuals• restrict access to birthing areas
• disposal of birth products
Pasteurization of milk Currently, no commercially available
vaccine in the United States Surveillance in researchers who work
with sheep
TAKE HOME
Zoonoses are common
Non-specific symptoms
Diagnostic tests difficult to interpret
Ask about risk factors