How to Prevent Q Fever (Coxiella Burnetii Infection)

Q fever (caused by infection of the bacteria Coxiella burnetii) is an animal-to-human infection. The illness brings severe flu-like symptoms, and is most commonly caught through contact with animals in a barnyard setting, especially when helping birth young.[1] Unlike many other bacterial infections, Coxiella burnetii is resistant to heat and to dry climate, and also shows resistance to common household disinfectants. The bacteria are very hardy, and can survive for some time unprotected in any environment.[2] Prevent yourself and others from catching Q fever by taking safety precautions when around animals that could be carriers of the disease.

Part 1 - Preventing Coxiella burnetii Infection

1

→ Know if you are at risk. Coxiella burnetii is excreted in the milk, urine, and feces of infected animals. Cows, sheep, and goats are the primary carriers, although other animals can carry the bacteria as well. The bacteria are also expelled in high numbers in the amniotic fluids and the placenta of birthing animals.

→ People who regularly work around livestock, including farm workers, sheep and dairy workers, and veterinarians, are examples of professions that are high-risk for Q fever. Workers in meat-processing plants and researchers who are in facilities that house livestock are also at a higher risk.

2

→ Wear a surgical mask to prevent bacteria inhalation. This is an easy way to guard your air intake, and is especially important if you may be exposed to Coxiella burnetii as part of your occupation. Anytime you are outside, in a barn or building where animals are housed, or otherwise engaging with livestock, plan to wear a surgical (or other mouth-covering) mask.

3

→ Consider the risk of other means of transmission. Although Coxiella burnetii is largely transmitted through contact with animals and their excreta, there are other means of transmission. Humans can contract Q fever through tick bites (if the tick is infected with Coxiella burnetii), through drinking infected unpasteurized milk, and through human-to-human contact.

→ Avoid tick bites by thoroughly searching over your body (especially armpits and groin) after time spent around livestock. Since ticks often seek out large animals, you can further protect yourself by spraying yourself or your clothes with an insect repellant such as DEET.

→ All unpasteurized milk must be labeled as such by FDA regulation, so it’s easy to avoid.

→ The likelihood of contracting Q fever through tick bite, bad milk, or human contact is very small.

Part 2 - Preventing the Spread Q Fever in a Facility

1

→ Limit access to facilities where infected animals are housed. It may be necessary to quarantine infected (or potentially infected) animals so that they do not pass the infection on to other animals or humans. Since the illness is so easily transmitted, it’s crucial to limit human contact with infected animals.

→ Quarantine all imported animals, until you can confirm that they are not infected.

2

→ Dispose of animal birth byproducts. These items commonly infect humans with Q fever and should be sanitarily disposed of immediately following an animal’s birth. Dispose of the placenta, birth products, fetal membranes, and aborted fetuses in an appropriate manner.

→ Always wear a face mask when dealing with animals giving birth. If Q fever is known or suspected in a herd or flock wear N95 or higher mask.

→ Wear rubber gloves and protective clothing when handling animal excreta.

→ Wash hands thoroughly and several times a day with disinfectant soap after any contact with animals. In particular, make sure you wash your hands after disposing of any animal bodily products.

3

→ Follow occupational safety practices. If you work in or manage people in an occupation that deals with livestock — including veterinarians, meat-processing technicians, sheep and dairy workers, livestock farmers, and sheep and livestock researchers — be sure to follow industry safety guidance to limit the transmission of Q fever. This may include wearing gloves and protective clothing.

→ Maintain strict and proper procedures for bagging, sterilizing, and washing of work clothing.

→ Insure that all personnel wear appropriate safety equipment.

→ Implement steps to prevent airflow from one animal housing area to other occupied areas (animal or human).

→ Educate employees about the infection and how it is spread. Those who have cardiac valvular disease should be made aware of the high risks involved.

→ Adhere to strict guidelines for sterilizing and dismantling or assembling meat-processing equipment.

4

→ Minimize the likelihood of a Q fever outbreak. Keep animal and human populations separate as much as possible, and prevent Q fever with medicine as much as possible. Vaccinate all persons engaged in research with pregnant sheep or live Coxiella burnetii when possible. Based on where your facility is located, you may or may not be able to legally use the Coxiella burnetii vaccine.

→ Locate all housing facilities for sheep away from areas populated by humans.

→ Routinely test animals for antibodies to the bacteria.

→ Wildlife or pets should not be able to scavenge birth products from the farm animals. These should be buried and composted or disposed of in a closed container.

Part 3 - Diagnosing and Treating Q Fever

1

→ Count the weeks following possible infection. Most people become sick within two to three weeks after exposure. Q fever typically runs its course in one week, at which point the symptoms will decline and vanish.

→ The Q fever incubation period varies depending on the number of bacteria that infect the patient initially. Infection with larger numbers results in shorter incubation periods.

→ Those who fully recover sometimes acquire lifelong immunity against reinfection.

2

→ Pay attention to flu-like symptoms. Only about half of people infected with Coxiella burnetii bacteria contract Q fever. Individuals sick with Q fever often experience severe nausea and fever, with other pronounced flu-like symptoms. These can include:

→ Sweats and chills.

→ Severe headache

→ Chest pain (when breathing) and other muscle aches

→ Vomiting and diarrhea

→ Abdominal pain

→ General malaise

3

→ Stay hydrated and rest. Since many of the symptoms of Q fever involve fluid loss, it’s important to drink plenty of fluids to avoid dehydration. Individuals sick with Q fever should also avoid spending time outside, especially in sunny climates, and should rest as much as possible.

→ Vomiting and diarrhea puts a sick individual at high risk of dehydration.

TIPS

→ Only a very small number of bacteria are be needed to cause an infection.

→ People are generally very susceptible to the disease.

→ Never consume unpasteurized milk and milk products.

→ Person-to-person transmission is very rare.

Warnings

→ Coxiella burnetii is highly infectious. It can become airborne and inhaled by humans, and is considered a potential terrorist threat.