Q fever - early
Q fever is an infectious disease that is spread by domestic and wild animals and ticks.
You can get Q fever by drinking raw (unpasteurized) milk, or after breathing in dust or droplets in the air that are contaminated with infected animal feces, blood, or birth products.
Symptoms usually develop 2 to 3 weeks after coming in contact with the bacteria. This time is called the incubation period. Most people have no symptoms. Others may have moderately severe symptoms similar to the flu. If symptoms occur, they may last for several weeks.
People at risk for infection include slaughterhouse workers, veterinarians, researchers, food processors, and sheep and cattle workers. Men are infected more often than women. Most people who get Q fever are between 30 and 70 years old.
This disease is occasionally seen in children, especially those who live on a farm. In infected children younger than 3 years old, Q fever is usually discovered while looking for the cause of pneumonia.
Common symptoms include:
Other symptoms that may develop include:
Exams and Tests
A physical examination may reveal abnormal sounds (crackles) in the lungs or an enlarged liver and spleen. In the late stages of the disease, a heart murmur may be heard.
Tests that may be done include:
- A chest x-ray to detect pneumonia or other changes
- Blood tests to check for antibodies to Coxiella burnetti
- Liver function test
- Complete blood count (CBC)
- Tissue staining of infected tissues to identify the bacteria
- Electrocardiogram or echocardiogram to look at the heart
Treatment with antibiotics can shorten the length of the illness. Antibiotics that are commonly used include tetracycline and doxycycline. Pregnant women or children who still have any baby teeth should not take tetracycline by mouth because it can permanently discolor growing teeth.
Most people get better with treatment. However, complications can be very serious and sometimes even life threatening. Q fever should always be treated if it caused the symptoms.
Rarely, Q fever causes a heart infection that can lead to severe symptoms or even death if untreated. Other complications can include:
- Bone infection (osteomyelitis)
- Brain infection (encephalitis)
- Liver infection (chronic hepatitis)
- Lung infection (pneumonia)
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of Q fever. Also call if you have been treated for Q fever and symptoms return or new symptoms develop.
Pasteurization of milk destroys the bacteria that cause early Q fever. Domestic animals should be inspected for signs of Q fever if people exposed to them have developed symptoms of the disease.
Marrie TJ, Raoult D. Coxiella burnetii (Q fever). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 189.
Raoult D. Rickettsial infections. In: Goldman L, Schafer AI,eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 335.
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.