Q fever - Chem-Bio-Rad Suspicion
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Cattle, sheep, and goats are the main reservoirs, and transmission to humans typically occurs by direct contact with the body fluids of infected animals and with inhalation of C burnetii in aerosolized body fluids and contaminated dust. Ingestion of contaminated milk or meat is a less common mode of transmission, as are tick bites.
Coxiella burnetii is resistant to heat, drying, and common disinfectants. In a bioterrorism attack, the most likely method of dispersal would be an aerosolized release. Q fever has been designated by the CDC as a Category B bioterrorism agent.
Very few organisms are required to cause illness. The incubation period of Q fever depends on the number of organisms in the exposure, although 2-3 weeks is typical. It may be as short as 5 days following a massive exposure, as might be the case in a bioterrorism attack.
Initial symptoms of Q fever include high fever, chills, headache, malaise, myalgia, confusion, sore throat, sweats, nausea, vomiting, diarrhea, and abdominal pain. Pneumonia with nonproductive cough, chest pain, and rales may occur in 30%-50% of cases after 4-5 days. Fever can persist for up to 2 weeks. Hepatitis may occur in some cases. The overall mortality rate is 1%-2%.
Chronic disease may develop and persist for more than 6 months. The chronic form can occur up to 20 years after initial infection. The disease may progress to endocarditis or aseptic meningitis. In some individuals, Q fever can affect the kidneys, thyroid, or genitals.
The prevalence of Q fever is unclear; half of those infected remain asymptomatic. Person-to-person transmission is not known to occur. Infection results in lifelong immunity.
Codes
A78 – Q fever
SNOMEDCT:
186788009 – Q fever
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