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Q fever is a bacterial infection caused by the coxiella burnetii bacteria. It causes flu-like symptoms such as a high temperature, muscle pain and headaches. Read more about the symptoms of Q fever.
In most people, the symptoms of Q fever will get better without treatment within two weeks. Antibiotics may be recommended if your symptoms are severe or do not improve. A less common, long-term form of Q fever requires antibiotics for several years. Read more about treating Q fever.
The ‘Q’ in Q fever stands for ‘query’. This is because when the infection was first indentified, its cause was unknown. The cause is now understood but the name has remained the same.
Catching Q fever
Q fever is spread to humans from animals, most commonly livestock such as sheep, goats and cattle. Very rarely, it can spread directly from human to human, usually during sexual intercourse. Read more about the causes of Q fever.
In England, people who are most at risk of getting Q fever are those whose occupation brings them into close contact with livestock, including:
In the UK, around 50 cases of Q fever are reported every year. However, the actual figure may be much higher because Q fever often causes only mild symptoms that can be mistaken for flu.
Q fever is more common during the lambing season (around January to April), but can occur at any time of year. It is also more common in agricultural areas.
Types of Q fever
There are two main types of Q fever:
Acute Q fever
Acute means short-term. Acute Q fever causes flu-like symptoms that last for a couple of weeks. Less commonly, acute Q fever can cause mild pneumonia (inflammation of the lungs), and mild hepatitis (inflammation of the liver).
Chronic Q fever
Chronic means long-term. In some cases, the symptoms of Q fever can last for six months or longer. This is called chronic Q fever. People with chronic Q fever will need to take antibiotics for at least three years to prevent the infection from reoccurring.
It is also possible for chronic Q fever to cause inflammation of the inner lining of the heart (endocarditis). Endocarditis is potentially very serious. Left untreated, it can affect the normal workings of the heart and lead to heart failure. With treatment, it is estimated that less than 1 in 10 people with endocarditis caused by Q fever will die.
There is no vaccine for Q fever available in the UK.
A vaccine for Q fever has been produced in Australia, but it has not been licensed for use here.
However, the Health and Safety Executive is currently working with the Joint Committee on Vaccinations to determine whether a routine vaccination should be made available to people in high-risk occupations.
Read more about preventing Q fever.
Acute Q fever
Q fever is usually a short-term (acute) condition.
The symptoms of acute Q fever usually develop two or three weeks after the initial infection, although it can be as little as two days or as long as 40 days after. The time it takes for symptoms to develop after infection is known as the incubation period. Symptoms include:
These symptoms can come on quite suddenly and usually last up to two weeks.
The pneumonia caused by Q fever is usually mild.
As with pneumonia, the hepatitis caused by Q fever is usually mild and many people will experience no obvious symptoms. Yellowing of your skin and the whites of your eyes (jaundice) is rare.
Chronic Q fever
In some cases, Q fever can become a long-term (chronic) condition. In chronic Q fever, the symptoms can last six months or longer after an acute Q fever infection. You may feel tired and generally unwell for months.
In a few rare cases, chronic Q fever can cause inflammation of the inner lining of the heart (endocarditis). This is more likely to occur if you already have damage to your heart valves, or if you have had heart bypass surgery.
Endocarditis can cause the following symptoms:
Read more about endocarditis.
Q fever in pregnancy
If you catch Q fever while you are pregnant, it often causes no symptoms. However, it can affect your unborn baby whether you experience any symptoms or not. It can cause:
Q fever is caused by bacteria known as coxiella burnetii (or c. burnetii). The bacteria are usually spread to animals by infected ticks. Samples of c. burnetii have been found in almost all types of animals, including reptiles and fish.
The most commonly affected animals, and those that pose the biggest risk to humans, are:
Most animals with Q fever do not experience any symptoms, so it can be difficult to tell if an animal is infected. However, the bacteria can cause an increase in miscarriages among an infected herd of cows or flock of sheep.
The bacteria can be released by an infected animal through its:
Birth by-products pose the greatest risk because they contain a high number of c. burnetii bacteria. For example, it is estimated that one gram of infected placenta contains enough bacteria to infect 100 million guinea pigs with Q fever.
How Q fever is spread to humans
Q fever can be spread to humans in a number of different ways. The c. burnetii bacteria are tough and can survive in the outside environment for up to six months. They can spread through:
It is possible that a bite from an infected tick could lead to Q fever, but there have not been any recorded cases of this in the UK.
Human to human transmission
It is possible, but very rare, to catch Q fever from another person.
Most experts believe that Q fever can only be transmitted from one human to another through:
Chronic Q fever
It is unclear why some people go on to develop the long-term (chronic) form of Q fever. Most cases of chronic Q fever develop in people with a pre-existing health condition, which makes them more vulnerable to infections. These health conditions include:
Vulnerability to infection is higher in people who have a weakened immune system, caused either by a health condition, such as HIV or AIDS, or as a side effect of certain medical treatments, such as chemotherapy or long-term steroid use.
Q fever can be diagnosed using a blood test.
If the c. burnetii bacteria that cause Q fever are present in your blood, your immune system (the body’s natural defence system) will produce a type of protein called an antibody to kill them. A sample of your blood will be tested at a laboratory for the presence of these antibodies. The antibodies should show up two or three weeks after you have been infected.
A sample of your blood can also be tested after you have been treated to check that the antibodies have gone.
In most people, the symptoms of Q fever will get better without treatment within two weeks.
You may need treatment with antibiotics if your symptoms:
Acute Q fever
If you have short-term (acute) Q fever, you may be prescribed doxycycline or tetracycline.
You will need to take these for 7-14 days and for at least three days after your fever has improved.
If you are prescribed antibiotics, it is important that you finish the whole course, even if you feel better. This will ensure that all the bacteria have been killed, preventing the infection from reoccurring.
Chronic Q fever
Long-term (chronic) Q fever can be difficult to treat because the c. burnetii bacteria, which cause Q fever, can be resistant to antibiotics. This means the antibiotics can’t kill them.
You will need to take a combination of antibiotics, such as doxycycline and chloroquine.
It is recommended that you take these for at least three years. However, the infection returns in more than half of people.
You may need to have blood tests every three to six months while you are being treated to check that the treatment is working.
If you have inflammation of the lining of your heart (endocarditis), you will need to be treated in hospital. Read more about treating endocarditis.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding and have Q fever you may be referred to a doctor who specialises in infectious diseases. They will advise you about your treatment.
If you work with animals, your employer has to ensure that preventative measures are in place to lower your risk of getting Q fever. For example, they must ensure that all animal birth products are disposed of properly and that access to infected animals is restricted.
You can also reduce your risk of getting Q fever by not drinking unpasteurised milk and dairy products, and by not touching anything that may have been in contact with animal blood, stools (faeces) or urine.
People who are particularly vulnerable to infection should avoid occupations that carry a high risk of exposure to Q fever. These occupations are:
People who are vulnerable to Q fever include:
If you are pregnant, avoid contact with sheep and lambs during the lambing season.
Pregnant women who come into close contact with sheep during lambing may risk the health of their unborn child because Q fever (as well as other sheep-borne infections) can cause miscarriages or stillbirths.
To avoid the possible risk of developing infections, pregnant women are also advised to avoid the following:
Some infections can pass from sheep to humans. If a pregnant woman becomes infected, it can harm her and her unborn baby's health.
If you’re pregnant, avoid close contact with sheep during the lambing season, which runs from January to April.
Infections that can cause problems
Infections that can cause female sheep (ewes) to miscarry include:
Another infection, Q fever, can also cause serious illness in pregnant women, although it rarely harms the unborn baby.
The risks are low
These infections are uncommon in sheep, and very rare in humans. The number of human pregnancies affected by contact with sheep is extremely small.
Although the risks are low, avoid close contact with sheep during lambing.
Advice for pregnant women
To avoid the risk of infection, pregnant women should follow the advice below:
Farmers are responsible for minimising the risk of pregnant women getting into close contact with sheep. This includes members of their family, the public and professional staff who visit their farms.
When to get medical advice
Seek medical advice if you’re pregnant and:
Animals can pass many infections to people, although this route of infection is rare. The medical name for these infections is zoonoses. They can be passed on in various ways, and different animals can pass on different infections.
Infections caused by parasites, insects and fungi
Animals can pass infections on through parasites, infected insects and fungi. Examples are:
Infections caused by food and water contaminated with bacteria
Infections can also be passed from animals to people through contaminated food and water.
Food poisoning can be caused by campylobacter bacteria found in:
Salmonella bacteria also cause food poisoning and can be found in:
Salmonella can also be passed on through contact with stools from infected animals such as reptiles.
Bacteria that less commonly cause food poisoning include:
Infections rarely or not found in the UK
Some human infections from animals are rarely found in the UK, including:
These infections are not currently found in the UK:
If you’re pregnant, it’s important to know that some infections from animals can damage your unborn baby or make you ill.
There are several ways you can reduce your risk of catching an infection from an animal. The medical name for infections that animals can pass to people is zoonoses.
Contact with animals
To reduce your risk of infection from an animal:
If you have a pet, follow your vet's advice about treating it regularly for infections such as worms.
Wash your hands thoroughly with soap and water:
Preparing and handling food
Take care when preparing and handling food:
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