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Q-Fever Guidelines

Q-fever is a Rickettsial disease caused by Coxiella burnetii. Humans, sheep, goats and cattle are the main hosts but other domestic and wild mammals and birds may be infected. Ticks can serve as a vector for the disease. Because of the disease prevalence in small ruminants all sheep and goats should be assumed to be infected unless their status has been determined by repeated serological testing.

Q-Fever

Transmission

Sources of infection include aerosols from contaminated bedding or dust and direct contact with infected animals, especially placenta and placental fluids. Organisms can be present in feces, urine, blood, milk and wool from infected sheep. As few as 10 inhaled organisms can cause an infection. The time of highest risk of contacting the disease is the periparturient period when large numbers of organisms are shed in the placenta and placental fluids. The organism is extremely resistant to drying and may survive for months or years in the environment.

Incubation period
2-3 weeks.

Clinical signs
In humans infection may vary from inapparent to severe. Signs are often flu like with fever, chills, headache, sweats, malaise, anorexia and weakness. Nausea, vomiting and diarrhea may also occur and death has occurred in 1% of the documented cases.
In animals the infection is usually inapparent but one may see sporadic abortions and/or anorexia. The organism frequently localizes in mammary glands, placenta and supramammary lymph nodes and animals can become asymptomatic carriers.

Diagnosis
In humans serology and skin testing can be utilized. In animals it is recommended that animals be tested serologically after each parturition to screen for Q-Fever. Repetitive negative tests offer a high assurance of lack of infection, however, there is no fool proof testing method available. Animals should be tested with both phase I and phase II immunofluorescence assays (IFAs). Phase II should be positive in an animal with an acute active infection and will convert later to positive on phase I.

IACUC Guidelines

All employees who may be exposed to C. burnetii should be notified of their risks and informed of the clinical signs of the disease. Immunocompromised individuals and those with valvular heart disease should not work with animals potentially infected with the disease. Women of child bearing age must be informed of the potential risk to themselves and to an unborn child. Pregnant women should not work with ruminants, especially sheep and goats, during the periparturent period. This should be discussed with the occupational health physician or their personal physician and any signs of the disease in persons working with ruminants should be reported to the occupational health physician.

All sheep and goats, unless repeatedly tested negative should be considered as potentially infected. If possible experimental procedures should be developed using male or non-pregnant female sheep and goats. New animals and animals of unknown Q-fever status should be tested with both phase I and phase II IFAs and treated as potentially infected until repeated negative annual testing is assured.

Infected laboratory animals should be maintained in Animal Biosafety Level 3 facilities since the organism may be shed in feces and urine and BL-3 practices should be used in collection or manipulation of tissues and while performing necropsies of infected animals.

Any invasive surgery of the abdominal cavity of a pregnant sheep or goat must be done in a dedicated surgery facility. The surgeon will be dressed in scrubs, sterile surgical gown, cap and mask. All personnel attending in the surgery will wear scrubs, cap and mask. Dedicated surgical footwear or disposable booties will be worn.

Handling During Lambing/Kidding

When working with naturally infected animals or small ruminants with an unknown Q-Fever status for one week prior to expected parturition to two weeks after the last birth the following precautions should be taken:

  1. Entry into the facility should be restricted, personal protective equipment including respiratory protection (8210 or full face respirator), goggles, gloves, outer coveralls and boots should be used.
  2. Outer coveralls and boots should be removed before leaving the animal area if outside.
  3. Disposable items should be double bagged, sealed, labeled "Q fever, biohazard" and incinerated.
  4. All laundry from the facility must be double bagged and autoclaved prior to laundrying.
  5. If animals are housed inside containment facilities, personnel should shower out; if held outside, wash hands at a minimum and then shower in a designated area.
  6. All contaminated bedding should be double bagged, labeled and incinerated on a daily basis.
  7. Areas should be properly disinfected with a 1:10 dilution of household bleach, a 5% solution of hydrogen peroxide or Lysol. The purpose of this policy is to set uniform standards for the care and use of animals maintained in individual departmental teaching and research colonies. It was felt that this was necessary since these animals may be kept for long periods of time and used in an variety of teaching and/or research protocols numerous times. The following sets minimum standards; each department is required to keep adequate records on each animal's general heath and use.