Q Fever

Q fever is a zoonotic illness spread in nature by contact with animal secretions. Its extremely high infectivity by the aerosol route and persistence in the environment make it a biologic threat. Following inhalation, a long incubation period of 10 to 20 days is seen. Subsequently, a self-limiting febrile illness characterized by chills, sweats, severe headache, cough, and myalgias develops. Patchy infiltrates are seen on chest x-ray, along with leukocytosis, and elevated transaminases. The illness is generally incapacitating but self-limited. Laboratory culture of the agent should not be attempted because only one organism is needed to cause infection. Specimens should be sent to U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) or the Centers for Disease Control and Prevention (CDC) for serologic testing (see TableJ 81.-..1). The antibiotic of choice is tetracycline or doxycycline for 5 to 7 days. Prophylactic antibiotic therapy should not be initiated until 8 to 12 days after exposure and should be given for 5 days. Tetracycline or doxycycline is currently recommended. Secondary transmission does not occur.

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