Summary

• Also known as Q fever, this is a worldwide, zoonotic disease caused by the gram-negative, obligate, intracellular bacterium Coxiella burnetii.
• Disease is acquired through inhalation of pathogen-contaminated dust or aerosols or contact with products of conception and, less commonly, urine, faeces, or milk of infected animals.
• The most common reservoirs of the bacteria are cattle, sheep, and goats, but other species of mammals, as well as birds and ticks, have been associated with human infection.
• Occupations at high risk are abattoir workers, meat handlers, farmers, veterinarians, and laboratory personnel. In recent years, Q fever cases have also been reported among military personnel stationed in Iraq and Afghanistan.
• The disease presents in 2 forms: acute infection (a self-limiting febrile illness with varying degrees of pneumonia and hepatitis) and chronic infection (mainly endocarditis).
• Acute infection can be treated with oral antibiotics for 14 to 21 days, but endocarditis and other forms of chronic Q fever require long-term antibiotic therapy.