Q Fever: Causes, Symptoms, Diagnosis and Treatment

Q fever is a rare disease caused by a bacterium, Coxiella burnetii (C. burnetii). Q fever causes flu-like symptoms, usually 2-3 weeks after exposure to the bacteria. While most people recover from Q fever on their own, more severe cases of Q fever require treatment with antibiotics.

Q fever

Who is likely to have Q fever?

Anyone can develop Q fever. The disease is more common among people exposed to livestock and other farm animals, especially sheep and goats. Q fever also occurs among people who consume contaminated, unpasteurized dairy products.

Is Q fever contagious?

Q fever only rarely spreads from person to person through sexual contact or blood transfusions, or from a pregnant woman to her fetus.

What causes Q fever?

Q fever is caused by exposure to the Coxiella burnetii bacteria. This bacteria is found in infected animal milk, urine, feces, and birth products, like amniotic fluid.

Most people are infected after inhaling the bacteria. Infection is also possible after consuming contaminated unpasteurized dairy products, like raw milk.

What are the symptoms of Q fever?

Q fever causes flu-like symptoms in almost half of all people infected with C. burnetii. Symptoms range from mild to severe and include:

  • Fever
  • Fatigue
  • Headache
  • Chills, sweats and muscle aches
  • Chest pain
  • Stomach pain, nausea, vomiting, and diarrhea
  • Weight loss

Less than 5 percent of people infected with C. burnetii develop chronic Q fever. This serious infection often causes inflammation of the heart valves (endocarditis) and liver (hepatitis). Both endocarditis and hepatitis are serious medical conditions requiring immediate treatment.

For many people, symptoms of chronic Q fever include:

  • Extreme fatigue
  • Bone and joint pain
  • Yellowed skin (jaundice)
  • Night sweats
  • Shortness of breath
  • Swelling in the arms and legs
  • Weight loss

What complications are associated with Q fever?

Pregnant women who develop Q fever are at increased risk for stillbirth and miscarriage. They are also more likely to have infants born prematurely and at lower than normal birth weight.

Severe Q fever infections cause complications like pneumonia (an infection causing inflammation in the lungs), hepatitis or endocarditis. Left untreated, severe Q fever infections are sometimes fatal.

How is Q fever diagnosed?

Your doctor diagnoses Q fever with a physical examination and a review of blood test results. It can be difficult to distinguish Q fever from other respiratory diseases. Be sure to tell your doctor if you have been around farm animals or animal products (such as manure), even several weeks before.

How is Q fever treated?

For most people, Q fever disappears on its own without treatment. In more severe cases, Q fever is treated with antibiotics, like doxycycline (Oracea®, Monodox®), for several weeks.

People living with chronic Q fever receive strong antibiotics and other medications, like hydroxychloroquine (Plaquenil®), for several months. For some people, treatment lasts as long as 18 months. Throughout this time, your doctor continues to monitor you for any other medical issues that may arise.

Can Q fever be prevented?

A vaccine against Q fever is available in Australia, but it is not approved for use in the United States.

You can lower your risk of developing the disease by avoiding exposure to farm animals like sheep, goats or cattle. Also, avoid consuming raw or contaminated dairy products.

What is the prognosis (outlook) for people with Q fever?

For most people, Q fever disappears on its own without treatment. For more severe infections, antibiotics provide effective treatment.

When should I call my doctor if I think I have Q fever?

If you develop any flu-like symptoms, especially after exposure to farm animals or raw milk, contact your doctor for an evaluation. It is possible to develop symptoms up to 3 weeks after exposure to the bacteria.

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