Q-Fever
Q-Fever
Personnel exposed to pregnant sheep or goats
Q-fever is a disease caused by a microorganism called Coxiella burnetii. This can be acquired by exposure to placental membranes and fetuses from infected sheep or goats. There is an especially high concentration of these infected materials in animals at the time that the animals give birth, so particular care needs to be used in handling new born animals, placental tissues and other products of conception. This would include the placenta, amniotic fluid, blood or soiled bedding. In addition, individuals who handle young sheep or goats up to six months of age are at higher risk, as are individuals who participate in the routine care of sheep or goats such as the animal care workers. This infection is extremely contagious and has been reported to be spread by aerosol.
In most individuals the disease manifests itself as an acute illness which could be mistaken for influenza. The person has high fevers up to 104o or 105o. These are accompanied by general malaise, significant muscle aches and pains, and very frequently by a cough. Up to half of the individuals who develop this acute disease will have a pneumonia which can be seen on chest x-rays. A large number of people will also develop hepatitis. In most patients the disease is self-limited and will resolve on its own after ten days to two weeks. In older or ill individuals this acute illness may take one to two months to resolve. Even though it will resolve on its own, it is generally better to treat the disease with tetracycline because this does reduce the duration of fever. It is extremely important that, should an employee who works with sheep or goats develop an influenza type infection, that he/she mention to their physician the possibility of Q- fever. Q-fever is something that would not routinely be thought of and this diagnosis is often missed. Rarely a person may develop a chronic infection with the Q-fever organism. This will happen in less than 1% of infected individuals. This manifests itself as endocarditis which is an infection on the valves of the heart. This is virtually always fatal when it does occur. 90% of the people who develop this have some previous problem with their heart valves. Because of this, people who have congenital heart disease, prior valvular heart disease, or who have a chronic immunocompromised state should not work with infected animals at the time of animal parturition. It is best that these individuals not work with sheep, goats and cattle at all. This can be determined on a case by case basis. Immunocompromised individuals would include persons with AIDS or a positive blood test for the AIDS virus, people who are immunocompromised because of medications which they take, and people who are immunocompromised because of certain chronic diseases.
In order to limit the spread of Q-fever there are a number of procedures which should be followed. Laboratories using sheep or goats and animal care areas housing these animals should be strictly off limits to anyone who does not have a specific need to be there. Gloves should always be used in handling the placentas and newborns of these animals. It is important that animals be transported carefully to avoid infecting others besides laboratory personnel. Potentially contaminated surfaces should be decontaminated with dilute solutions of chlorine bleach or dilute solutions of Lysol. These organisms are quite resistant to destruction and many ordinary methods of disinfecting will not be adequate. It is extremely important that laboratory doors be kept closed when experiments are in progress. Employees working with potentially infected tissue need to wear protective clothing that is not worn outside the area.
There is no effective vaccine to protect humans from Q- fever. Serum tests may be done to see if you have been exposed to Q-fever.