Q fever primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Effective measures for the primary prevention of Q fever include educating the public on sources of infection, appropriate disposal of the placenta, birth products, fetal membranes, and aborted fetuses at facilities housing sheep and goats, and restricting access to barns and laboratories used to house potentially infected animals.

Prevention

In the United States, Q fever outbreaks have resulted mainly from occupational exposure involving veterinarians, meat processing plant workers, sheep and dairy workers, livestock farmers, and researchers at facilities housing sheep. Prevention and control efforts should be directed primarily toward these groups and environments.

The following measures should be used in the prevention and control of Q fever:[1]

  • Educating the public about sources of infection
  • Disposing of placenta, birth products, fetal membranes, and aborted fetuses at facilities housing sheep and goats appropriately
  • Restricting access to barns and laboratories used to house potentially infected animals
  • Using only pasteurized milk and milk products
  • Using appropriate procedures for bagging, autoclaving, and washing of laboratory clothing
  • Vaccinating (when possible) individuals engaged in research with pregnant sheep or live C. burnetii
  • Quarantining imported animals
  • Ensuring that holding facilities for sheep are located away from populated areas. Animals should be routinely tested for antibodies to C. burnetii, and measures should be implemented to prevent airflow to other occupied areas
  • Counseling persons at highest risk for developing chronic Q fever, especially persons with preexisting cardiac valvular disease or individuals with vascular grafts

Q fever vaccine

  • An intradermal vaccine composed of killed Coxiella burnetii organisms has been developed and has successfully protected humans in occupational settings in Australia. However, this vaccine is not commercially available in the United States.[2]
  • In 2001, Australia introduced a national Q fever vaccination program for people working in "at risk" occupations.
  • Persons wishing to be vaccinated should first have a skin and blood test to determine a history of previous exposure. Individuals who have previously been exposed to C. burnetii should not receive the vaccine because severe reactions localized to the area of the injected vaccine may occur.
  • After a single dose of vaccine, protective immunity lasts for many years and revaccination is not generally required.
  • A vaccine for use in animals has also been developed, but it is not available in the United States.[3]

References

  1. Fenollar F, Fournier PE, Carrieri MP, Habib G, Messana T, Raoult D (2001). "Risks factors and prevention of Q fever endocarditis". Clin. Infect. Dis. 33 (3): 312–6. doi:10.1086/321889. PMID 11438895.
  2. Ackland JR, Worswick DA, Marmion BP (1994). "Vaccine prophylaxis of Q fever. A follow-up study of the efficacy of Q-Vax (CSL) 1985-1990". Med. J. Aust. 160 (11): 704–8. PMID 8202006.