What Is Q Fever: Causes, Symptoms, Treatments And Prevention

Do you frequently work with animals? Do you live near a farm or have exposure to livestock? If so, you’re more likely than others to get an infection called Q fever. Q fever is an infection you get from a bacterium, Coxiella burnetii. People who have contact with animals are at risk of getting Q fever because it occurs in animals. The symptoms of Q fever, such as headaches, muscle aches, fever, and tiredness, are similar to the flu, so sometimes, this condition is difficult to diagnose. Most cases of Q fever are mild and don’t need treatment, but if your case is severe, doctors may treat you with antibiotics. If you think you might have Q fever, read on to learn more about it.

Causes and Transmission

How do you get Q fever? A bacterium called Coxiella burnetii, or C. burnetii, causes the condition. It can be found in the feces, urine, milk, and birth products of many animals, including cattle, sheep, and goats. Q fever transmission occurs when you breathe in air that is contaminated with the bacteria. If you are a farmer, veterinarian, or work with animals, you are more likely to get Q fever. Drinking dairy products that haven’t undergone pasteurization, a process that kills bacteria, can also get you sick with Q fever.

Q fever is not very contagious. It only rarely spreads from person to person.

Signs and Symptoms of Q Fever

If you get Q fever, you’ll usually get some of these symptoms:

Fever
Chills or sweats
Tiredness
Headaches
Muscle aches
Nausea, vomiting, or diarrhea
Chest pain
Stomach pain
Weight loss
Cough without phlegm

Q fever symptoms are similar to other conditions like the flu. In severe cases, you may get an infection of the lungs, brain, or liver.

How long does Q fever last? You usually feel sick two to three weeks after exposure, and the symptoms can last two to six weeks. However, some patients will develop chronic Q fever, which develops months or years after the initial Q fever infection. You’re more likely to get chronic Q fever if you have heart disease, kidney disease, or a weak immune system.

Complications

If you have chronic Q fever, you can get several complications:

Endocarditis: Endocarditis is an infection of the heart that leads to inflammation. This inflammation can damage the heart valves, which control blood flow through the heart. Symptoms of endocarditis include night sweats, tiredness, difficulty breathing, weight loss, and swelling of the limbs.
Lung issues: Q fever can infect the lungs and cause pneumonia. It can also cause acute respiratory distress, a medical emergency where fluid builds up in the air sacs of the lungs.
Pregnancy problems: If you get Q fever while pregnant, you may be at increased risk of miscarriage, stillbirth, pre-term delivery, or low infant birth weight.
Liver damage: Sometimes Q fever can lead to hepatitis, an inflammation of the liver that prevents it from functioning normally.
Meningitis: Q fever can cause meningitis, an inflammation of the lining surrounding the brain and the spinal cord.

Diagnosis of Q Fever

Q fever is difficult to diagnose because it has no specific diagnostic test and can be mistaken for the flu. Doctors usually diagnose Q fever by asking about your symptoms, determining if you have frequent contact with animals, running blood tests, and doing imaging tests.

Your doctor may check your blood for:

Elevated white blood cell count
Antibodies against C. burnetii bacteria
Signs of liver damage

Imaging tests can help with a Q fever diagnosis:

Chest X-ray: Q fever can cause pneumonia, so your doctor may get a chest X-ray to see if your lungs are infected.
Echocardiogram: If your doctor thinks you have chronic Q fever, they might order an echocardiogram, or a picture of the heart, to check for problems with the valves of the heart.

Prevention

If you work with animals on a regular basis, there are steps you can take to avoid getting Q fever:

Wash your hands and arms thoroughly after you have contact with animals.
Wear a properly fitted mask when handling animal products or working in an area with livestock.
When possible, wash surfaces and equipment contaminated with animal feces, urine, blood, and other animal body fluids.
Remove and wash dirty clothes, coveralls, and boots worn during high-risk activities, and avoid taking these items home. If you must take them home, bag and wash them separately from your other clothing.

A vaccine against Q fever has been developed in Australia for people in high-risk occupations. However, it is not yet approved for use in the US.

Treatments for Q Fever

Acute Q fever is treated with an antibiotic called doxycycline twice daily for 2 weeks.

If you develop chronic Q fever, your doctor will give you a medication called hydroxychloroquine in addition to doxycycline for at least a year. Your doctor will also follow up with you for years after treatment to make sure the infection hasn’t returned. If you have endocarditis from Q fever, you may require surgery to replace damaged heart valves.

Next Steps

If you have flu-like symptoms after exposure to farm animals or consumption of raw milk, talk to your doctor about how you’re feeling. You may not feel any symptoms for a few weeks after your exposure, so keep that in mind when telling your doctor about your condition. If you suspect that you have chronic Q fever, let your doctor know about any past infection with Q fever.

Resource Links:

“Q Fever” via CDC
“Q Fever” via Cleveland Clinic
“Q Fever” via Mayo Clinic
“Q Fever Fact Sheet” via NSW
“Q Fever Vaccine Development: Current Strategies and Future Considerations’ via Pathogens
“Q Fever” via StatPearls