Q fever

Background

• Described in 1937: occupational disease of abattoir workers (manage animals before and after slaughtering process) and dairy farmers
• Caused by Coxiella burnetii
• Obligate intracellular bacteria morphologically similar to Rickettsia
• Reservoirs include cattle, goat, sheep, and ticks (Dermacentor andersoni)
• CDC: category B biologic warfare agent due to its inhaled infectivity
• Worldwide disease

Clinical Features

• Symptoms usually develop within 2-3 weeks, although up to half of those infected may not show symptoms
  • high fevers (up to 104-105°F)
  • severe headache
  • general malaise
  • myalgias
  • chills/sweats
  • non-productive cough
  • nausea/vomiting
  • diarrhea
  • abdominal pain
  • chest pain
• Complications include pneumonia, granulomatous hepatitis (inflammation of the liver), myocarditis (inflammation of the heart tissue), and central nervous system complications.
• Endocarditis is the major form of chronic disease
• Infection in pregnancy is more likely to be asymptomatic, but often results in chronic Q fever and obstetrical complications

Differential Diagnosis

Fever in traveler

• Normal causes of acute fever!
• Malaria
• Dengue
• Leptospirosis
• Typhoid fever
• Typhus
• Viral hemorrhagic fevers
  • Ebola virus disease
  • Marburg virus disease
  • Lassa fever
  • Crimean-Congo hemorrhagic fever
• Chikungunya
• Yellow fever
• Rift valley fever
• Q fever
• Amebiasis
• Zika virus