Q fever is a bacterial infection that can affect the lungs, liver, heart, and other parts of the body.
Causes, incidence, and risk factors
Q fever is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks, as well as some other animals. Infected animals shed this bacteria in:
Humans usually get Q fever by breathing in contaminated droplets released by infected animals. Drinking raw milk has also caused infection in rare cases. People at highest risk for this infection are:
Laboratory workers who work with Coxiella burnetii
Sheep and dairy workers
Chronic Q fever develops in people who have been infected for more than 6 months.
People at highest risk include those with heart valve problems or weakened immune systems.
It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported.
Symptoms of acute Q fever may include:
Chest pain with breathing
Rash (not common)
Shortness of breath
Symptoms of chronic Q fever may include:
Shortness of breath
Signs and tests
The health care provider will suspect Q fever in people who have been exposed to the Coxiella burnetii bacteria who develop:
Q fever is diagnosed with a blood antibody test (serology).
The main treatment for Q fever is with antibiotics. For early-stage (acute) Q fever, doxycycline is the recommended antibiotic.
For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used. You may need to take antibiotics for several months.
The outlook for people who get treated in the early stages of Q fever is generally good.
Chronic Q fever requires long-term treatment with antibiotics. Your health care provider should check you often to make sure the disease has not returned.
Notify your medical provider if you have symptoms of Q fever, especially if you believe you have been exposed to the bacteria. Although many different illnesses can cause similar symptoms, you may need to be evaluated for Q fever.
People at risk (for example, farmers and veterinarians) should always:
Carefully dispose of animal products that may be infected
Disinfect any contaminated areas
Thoroughly wash your hands
Pasteurizing milk can also help prevent Q fever.
Prompt treatment can prevent early Q fever from becoming chronic.
Marrie TJ, Raoult D. Coxiella burnetii (Q fever). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 189.
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital.