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IACUC Policies Q Fever Last updated: March 2005 Q fever is a disease caused by the rickettsial organism, Coxiella burnetti. Sheep are the most common carriers of the disease agent, but cattle, goats, and other warm-blooded animals, like birds, can also be affected. When animals are infected, Coxiella localizes to organs and tissues associated with reproduction, such as the uterus, placenta, mammary glands, and lymph nodes draining the mammary glands. Infection of the placenta may cause abortion. Large numbers of organisms may be discharged with the placenta, amniotic fluid, and dead fetuses. Some infected animals may become chronic carriers of Coxiella yet show no signs of disease. Q fever is a concern when humans are working with sheep for research purposes, particularly when sheep are housed indoors. Coxiella burnetti is highly infectious, and only 1 to 10 infectious organisms are required to cause infection in humans. The highest risk of exposure is encountered when working with pregnant sheep, particularly during abdominal or fetal surgery or husbandry associated with lambing. The most common route of infection is inhalation of infectious organisms from placental tissues or fluids, from contaminated animal bedding or human clothing, or from wool. The incubation of Q fever in humans is 2 to 4 weeks. Clinical signs are suggestive of flu-like illness, including fever, chills, muscle aches, severe headache (typically behind the eyes), and profuse sweating. Nausea and vomiting is occasionally reported. The fever may last for 9 to 14 days and may recur later. The severity of disease is highly variable between individuals, so some persons with Q fever may show no signs at all while others become very ill. A chronic infection may develop in a small number of infected individuals, causing endocarditis, pneumonitis, pericarditis, and/or hepatitis. Persons at highest risk for cardiac-associated chronic disease are those with valvular disease or implants. Pregnant women infected with Coxiella burnetti may have abortions as a result of infection. The mortality rate in humans from Q fever is very low, about 1%. Diagnosis of Q fever in humans is based on clinical signs, history of possible exposure, and blood testing for antibodies to Q fever. Generally, 2 blood samples collected 2 to 3 weeks apart are necessary for diagnosis. Treatment may be prescribed by a physician and is usually from the tetracycline family of antibiotics. Doxycycline is often used because of its convenient twice daily dosing. Sheep can also be tested for the presence of antibodies against Coxiella burnetti. However, antibody titers are not always reliable at positively identifying sheep that do not carry the disease. Therefore, the Institutional Animal Care and Use Committee has developed a set of recommended practices to minimize the risk of exposure of research personnel to potentially infected sheep while not overly restricting the availability of research animals.
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