Most people have probably never heard of Q fever and will ask what is Q fever? Although relatively uncommon, certain occupations, locations, gender and even time of year present higher risk factors. Q fever is caused by a bacterium called Coxiella burnetti which is common in cows, sheep, and goats. Domesticated animals such as cats and dogs can also be infected. The infection is spread through contact with animal waste, urine, milk, and through birthing products like the placenta and amniotic fluid. When these materials dry the spores can be inhaled through the barnyard airborne particles.
Occupations at greatest risk of contracting the disease are veterinarians, farmers, shearers, stockyard workers, animal transporters, and laboratory technicians handling infected samples. Even being near or working on a farm can put one at risk as the bacteria can travel long distances via airborne particles and can live on surfaces for up to 60 days. Men are at greater risk for developing symptomatic acute Q fever. Although infections can happen year round it is highest in the months of April and May in the United States.
The typical incubation period is two to four weeks. Almost half of those infected never exhibit symptoms. Those that do exhibit how to cope with q fever will often present as flu-like including high fever (105 F), extreme lethargy, severe headache, profuse perspiration, muscle and joint pain, cough, nausea, diarrhea, chills and vomiting. The disease can progress into atypical pneumonia which can then lead to acute respiratory distress syndrome or ARDS which is life-threatening. This can occur as early as 4 to 5 days after infection. Less often the disease can cause granulomatous hepatitis.
Recurrences of Q fever can affect the heart in the form endocarditis (inflammation of the inner lining), lung issues such as pneumonia, and pregnancy complications and issues such as low birth rate, miscarriages, premature birth and stillborn infants. Hepatitis and meningitis have also been reported. In farm animals, the disease is well-known to cause abortions in ruminants (cows, goats, sheep). Diagnosis is made through blood tests to check for antibodies to Coxiella burnetti and also liver damage.
Antibiotics are extremely effective against the disease and treatment is often under the care of an infectious disease specialist. Commonly used antibiotics include tetracycline, doxycycline, ciprofloxacin, ofloxacin, chloramphenicol and hydroxychloroquine. Treating the acute form of the disease usually last 2-3 weeks. Treating the chronic form of the disease is more difficult. Patients must take doxycycline with hydroxychloroquine or doxycycline quinolones for a minimum of 18 months up to 4 years. Even after successful treatment, patients still need to return for follow-up tests for years in case the infection reoccurs. There is a Q fever vaccine developed and used in Australia with much success. The vaccine is not approved for use in the United States, however.