Q fever

Abstract

Tuberculosis and brucellosis have virtually been eradicated from cattle in Scotland, England, and Wales, and so Q fever is now the most serious and potentially chronic systemic zoonosis transmissible to man from animals in these countries. C. burnetii is widespread, and, unlike Mycobacterium tuberculosis and Brucella abortus, Q fever infection in animals is nearly always subclinical. Therefore farmers and veterinary surgeons have no financial incentive to seek methods of eradicating the disease from their cattle and sheep. A killed Q fever vaccine is being evaluated in cattle in the United States. As a practical preventive measure patients being prepared for heart valve replacement who live, or have lived, in rural areas, especially if they have been in contact with farm animals, could be screened for phase I antibodies. Those who work in abattoirs, or whose hobbies or recreation take them into the countryside, might also be tested. Patients who are found to have antibodies could then be given a preoperative course of a tetracycline to eradicate any latent focus of infection.