Q Fever (Acute): Treatment

The incubation period of Q fever is 3–30 days. The symptoms are nonspecific and mainly consist of fever, extreme fatigue, and severe headache. Chills, sweats, nausea, vomiting, and diarrhea may also occur. Cough is seen if patient develops Q fever pneumonia. Thrombocytopenia occurs in about 25% of patients, and reactive thrombocytosis with platelet counts sometimes exceeding 106/µL can develop during recovery.

Acute Q fever can complicate pregnancy and cause premature birth, abortion or neonatal death. Q fever in children is generally asymptomatic. Some cases of Q fever can lead to endocarditis (Q fever endocarditis).

Diagnosis: Diagnosis is by serology. Indirect immunofluorescence is sensitive and specific and is the method of choice for diagnosis. PCR (polymerase chain reaction) detects C. burnetii DNA in tissues.

Treatment of Q fever: Treatment of choice in acute Q fever is doxycycline 100 mgs twice a day for two weeks (14 days). Quinolones like ciprofloxacin, ofloxacin and gatifloxacin are also successful. Treatment of Q fever in pregnancy is with trimethoprim-sulfamethoxazole.

Prevention: A whole-cell vaccine (Q-Vax) is licensed in Australia and effectively prevents Q fever in abattoir (slaughterhouse) workers. Skin testing with intradermal diluted C. burnetii vaccine is done before administering vaccine. A history of possible Q fever is sought and vaccine is given only to patients with no history of Q fever and negative results in serologic and skin tests.

Good animal-husbandry practice is very important to prevent contamination of environment by C. burnetii. Only seronegative animals should be permitted in zoos.

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