Q Fever: Symptoms, Causes, Diagnosis, Treatment & Prevention

 

The bacteria C. burnetii are the cause of the uncommon disease known as Q fever. The most common way to contract it is by inhaling dust contaminated with the body fluids of an infected animal. Chronic Q fever is a serious illness that can harm your heart and other organs. If you have a history of blood vessel or heart valve problems, you are more likely to develop chronic Q fever.

The bacterium Coxiella burnetii is the cause of Q fever. Goats, sheep, and cows are among the species that are naturally infected by these germs. These bacteria are present in the milk, urine, feces, and birth products (such as placenta and amniotic fluid) of infected animals. Infected animal excrement, urine, milk, and birth products can contaminate dust, which can then infect humans. While some people never become sick, those who do typically have flu-like symptoms, such as chills, fever, exhaustion, and muscular soreness. After contracting the infection, some people experience chronic Q fever.

Also Read:Immune System Function & Disorder

What is Q fever?

Dust or animal products harboring the bacteria Coxiella burnetii (C. burnetii) can cause Q fever. C. burnetii can be carried by cattle, sheep, goats, and other animals. It can spread to individuals by penetrating the soil near them.

Why is it called Q fever?

In Q fever, the letter "Q" stands for question. When patients first began contracting it (in the 1930s in Australia and the 1940s in the United States), it was known as "query fever" because medical professionals were unsure of its source. As a result, they were curious about what was causing the fever.

What is Chronic Q fever?

A severe type of Q fever that can impact your heart, blood vessels, bones, and other body components is called chronic Q fever. One to five percent of those who have had an infection with C. burnetii are affected. It can cause life-threatening complications and begin months or years after your initial symptoms subside. Sometimes people with chronic Q fever had no symptoms with their initial infection. The most common form causes inflammation in your heart (endocarditis).

Who is most susceptible to severe Q fever?

Some people are more susceptible to Q fever's severe side effects. Miscarriage and pregnancy problems are more likely to occur in pregnant women. A more serious condition than acute Q fever, chronic Q fever is more likely to strike you if you:

• Have a history of aneurysms, endocarditis, cardiac valve problems, or renal insufficiency.

• Own a vascular prosthesis—a permanent, implanted device that improves blood flow and strengthens blood vessels.

• Possess a weakening of the immune system.

Which symptoms of Q fever are present?

Three to thirty days after exposure, the flu-like first symptoms of Q fever appear. Q fever fatigue syndrome (QFS) is a condition in which some persons experience symptoms for more than a year following their first encounter. Others get signs of chronic Q fever, a more serious infection.

Symptoms of acute Q fever

Acute Q fever symptoms can vary greatly, but they typically resemble the flu. Pneumonia, liver inflammation (hepatitis), or inflammation of the brain or its covering (encephalitis or meningitis) are possible outcomes. Among the symptoms you may encounter are:

• Fever

• Extreme fatigue

• Chills

• Sweating

• Aches in the muscles

• Photophobia, or light sensitivity

• Severe headaches

• Vomiting and nausea

• Diarrhea

• Cough

• Chest discomfort

• Stomach ache

• Purpura, or rash-like patches beneath your skin

• Shortness of breath (Dyspnea)

Q fever fatigue syndrome symptoms (QFS):

Fatigue and other symptoms that persist for months or years after initial exposure are experienced by 20% of individuals with Q fever. Q fever tiredness syndrome symptoms include:

• Extreme exhaustion

• Headaches

• Sweating

• Pain in the joints

• Aches in the muscles

Chronic Q fever symptoms (persistent Q fever)

Even if you were symptom-free when you first contracted C. burnetii, chronic Q fever can develop months or years later. Although your heart, heart valves, and blood arteries are the most frequently damaged, the symptoms can differ depending on the body parts that are impacted.

Chronic Q fever symptoms include:

• Low-grade fever

• Sweats at night

• Reduction of weight

• Exhaustion

• Shortness of breath

• Swelling in the feet or legs

What is the cause of Q fever?

Q fever is brought on by the bacteria Coxiella burnetii. Cattle, sheep, and goats are the most common animals that can carry C. burnetii without exhibiting any symptoms. People may inhale dust or mist from contaminated soil that contains bodily fluids from diseased animals, such as urine, feces, milk, and birthing products like amniotic fluid.

Q fever complications:

Complications are possible with both acute and chronic Q fever, but they are more frequent and typically more serious in the more common. Among the complications are:

• Aneurysm: weak, bulging arteries

• An abnormal blood flow is caused by an arterial fistula

• Infection of the heart (endocarditis)

• Your lungs' scarring (fibrosis)

• ARDS, or acute respiratory distress syndrome

• Heart failure

• Osteomyelitis, or bone infection

• Loss of pregnancy (miscarriage)

• Low weight at birth

Diagnose:

To diagnose Q fever, your doctor will take a blood sample, interview you about your symptoms, and review your medical history.  They could also inquire as to whether you work or reside near animals.

 It may take a few weeks to get C. burnetii test results.  Your doctor may choose to treat you before the findings are in if they think you have Q fever.

 How is Q fever tested for?

Your healthcare professional will use a tiny needle to draw blood to test for Q fever.  Your sample will be submitted to a laboratory to test for antibodies and look for indications of a C. burnetii infection.  Additionally, they might attempt to cultivate C. burnetii using your sample.

To obtain a conclusive diagnosis, you might have to submit several samples over time.

What is the treatment for Q fever?

 Antibiotics are used to treat acute Q fever.  Although it can be challenging to cure, a combination of antibiotics and anti-inflammatory drugs is frequently used to treat chronic Q fever.  A treatment plan tailored to your particular ailment will be developed by your provider.

 Consult your healthcare practitioner about receiving preventive treatment to lower your risk of developing chronic Q fever if you have been diagnosed with the illness and have a history of heart valve or blood vessel disorders.

Which medications/treatments are used?
Your doctor might recommend:

• Doxycycline

• Hydroxychloroquine

• TMP-SMX stands for trimethoprim-sulfamethoxazole

• Rifampin

• Ciprofloxacin and Ofloxacin are examples of fluoroquinolones

• Clarithromycin

Is there a cure for Q fever?
Yes, most people with acute Q fever can recover with antibiotics. Even after treatment, a small percentage of patients with acute Q fever may experience symptoms that last for months or years. Curing chronic Q fever can be more difficult.

Prevention:

Here are some strategies to lower your risk of Q fever:

• Avoiding contact with animals, especially during animal births, can lower your risk of contracting Q fever. Coxiella burnetii infections can occur in animals that seem healthy.

• Discuss your risk of getting persistent Q fever with your healthcare provider if you have been diagnosed with the illness and have a history of heart valve disease, blood vessel abnormalities, a compromised immune system, or are pregnant.

• When handling animal fluids, particularly birthing products, put on gloves and a mask.

• Avoid consuming dairy products that have not been pasteurized.

• Ask your healthcare provider about getting vaccinated if you work in a high-risk job and live in a region where the Q fever vaccine is available (at the moment, only in Australia).

References:

• Walker DH, Dumler J, Blanton LS, Bleeker-Rovers CP. Rickettsial Diseases. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson J, eds. Harrison’s Principles of Internal Medicine. 21st ed. McGraw Hill; 2022.

• van Roeden SE, Wever PC, Kampschreur LM, et al. Chronic Q fever-related complications and mortality: data from a nationwide cohort. (https://pubmed.ncbi.nlm.nih.gov/30543852/) Clin Microbiol Infect. 2019 Nov;25(11):1390-1398. Accessed 9/20/2022.

• Million M, Raoult D. No Such Thing as Chronic Q Fever (https://pubmed.ncbi.nlm.nih.gov/28418317/). Emerg Infect Dis. 2017;23(5):856-857. Accessed 9/20/2022.

• U.S. Centers for Disease Control and Prevention. Q Fever. (https://www.cdc.gov/qfever/index.html) Accessed 9/20/2022.

• Morroy G, Keijmel SP, Delsing CE, et al. Fatigue following Acute Q-Fever: A Systematic Literature Review. (https://pubmed.ncbi.nlm.nih.gov/27223465/) PLoS One. 2016 May 25;11(5):e0155884. Accessed 9/20/2022.