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SECTION I - INFECTIOUS AGENT
NAME: Coxiella burnetii
SYNONYM OR CROSS REFERENCE: Q fever, Query fever, Rickettsia.
CHARACTERISTICS: Pleomorphic, gram-negative bacteria.
SECTION II - HEALTH HAZARD
PATHOGENICITY: Acute febrile disease; sudden onset, chills, headache, weakness, malaise, severe sweats;
pneumonitis, pericarditis, hepatitis, endocarditis, generalized infections; some inapparent infections; < 1%
case fatality rate, self limiting infection.
EPIDEMIOLOGY: Worldwide; incidence is greater than reported; endemic in many areas; explosive epidemics
occurred in stockyards, meat packing plants and medical labs using sheep for research; common cases in researchers
and visitors.
HOST RANGE: Humans, cattle, sheep, goats.
INFECTIOUS DOSE: 10 organisms by inhalation route.
MODE OF TRANSMISSION: Commonly by airborne dissemination of rickettsia in dust from contaminated premises;
airborne organisms may be carried >1/2 mile downwind; by direct contact with infected animals and their birth
products (especially sheep), wool from sheep, straw, fertilizer and laundry of exposed persons; raw milk from infected
cows has been responsible in some cases.
INCUBATION PERIOD: Depends on size of the infecting dose; usually 2-3 weeks.
COMMUNICABILITY: Direct transmission from person to person is very rare, but may occur in cases of pneumonia.
SECTION III - DISSEMINATION
RESERVOIR: Sheep, cattle, goats, ticks, some wild animals (bandicoots); infected domestic animals are
usually asymptomatic but shed massive numbers of organisms at parturition.
ZOONOSIS: Yes - direct contact with infected animals (particularly placenta and placental fluids); inhalation
of aerosols from infected animals, bedding, dust, etc.
VECTORS: Ticks - several species.
SECTION IV - VIABILITY
DRUG SUSCEPTIBILITY: Resistant to many antibiotics; tetracycline, chloramphenicol and rifampin may be
effective.
SUSCEPTIBILITY TO DISINFECTANTS: Resistance to disinfectants documented; reported susceptibility to sodium
hypochlorite, formalin, phenols varies; susceptible to ethanol, glutaraldehyde and gaseous formaldehyde (humidity
control is essential).
PHYSICAL INACTIVATION: Resists elevated temperatures, dessication, osmotic shock, UV; inactivated by ether,
chloroform, gamma irradiation, 130o C for 60 imin.
SURVIVAL OUTSIDE HOST: Extremely resistant to drying and is stable under a variety of environmental conditions;
survives for months and even years in the environment; dried sputum - 30 days; dust - up to 120 days; dried urine
of guinea pig - 49 days; feces of tick 586 days- milk - 42 months at 4-6o C; wool 12-16 months at 4-6o
C.
SECTION V - MEDICAL
SURVEILLANCE: Monitor for symptoms of infection; confirm serologically.
FIRST AID/TREATMENT: Antibiotic therapy, typically with doxycycline.
IMMUNIZATION: Investigational - Phase I Q fever vaccine (IND) available from USAMRID recommended for those
at high risk (those who work with live C. burnetii and sheep) of exposure who have no demonstrated sensitivity
to Q fever antigen; Australian vaccine also found to be effective.
PROPHYLAXIS: Antibiotic prophalaxis not shown to be effective.
SECTION VI - LABORATORY HAZARDS
LABORATORY-ACQUIRED INFECTIONS: Second most commonly reported laboratory infection with outbreaks involving
15 or more persons recorded in several institutions; 278 reported cases with 1 death.
SOURCES/SPECIMENS: A broad range of domestic and wild mammals are natural hosts and may serve as potential
source of infection to laboratory and animal care personnel; infected arthropods; blood, urine, feces, milk, and
tissues of infected animal or human hosts; placenta of infected sheep may contain millions of organisms/gram tissue;
milk may contain 100,000 organisms/gram.
PRIMARY HAZARDS: Parenteral inoculation; exposure to infectious aerosols and droplets.
SPECIAL HAZARDS: Exposure to naturally infected and often asymptomatic sheep and to their birth products
is a documented hazard to personnel.
SECTION VII - RECOMMENDED PRECAUTIONS
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices and containment for nonpropagative laboratory procedures,
including serological examinations and staining of impression smears; biosafety level 3 practices and facilities
for activities involving the inoculation, incubation, and harvesting of embryonated eggs or tissue cultures, the
necropsy of infected animals and the manipulation of infected tissues.
PROTECTIVE CLOTHING: Laboratory coat; gloves and gown (tight wrists and fastened in back) when working with
the agent; masks may also be used.
OTHER PRECAUTIONS: Since infected guinea pigs and other rodents may shed the organisms in urine or feces,
experimentally infected rodents should be maintained under Animal Biosafety Level 3.
SECTION VIII - HANDLING INFORMATION
SPILLS: Allow aerosols to settle; wear protective clothing; gently cover spill with paper towels and
apply 1% sodium hypochlorite (20% commercial bleach), starting at perimeter and working towards the center; allow
sufficient contact time (30-60 min) before clean up.
DISPOSAL: Decontaminate all wastes before disposal; incineration (animal wastes), steam sterilization,
STORAGE: In sealed containers that are appropriately labeled.
Date prepared: October 11, 1997 Prepared by: Canadian Office of Biosafety Information edited by the Colorado State
University Office of Biosafety; June 16, 1998.
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