News Release: School of Public Health

Feb. 17,  2009

U.S. Veterinarians at Risk for Q Fever

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U.S. veterinarians face a high risk of exposure to the bacteria that cause Q fever, according to a study published online by the journal Clinical Infectious Diseases. The study currently is online and will appear in the March issue of the journal.

Q fever is a disease caused by infection with Coxiella burnetii bacteria, which are commonly carried by sheep, goats and cattle. People who have contact with farm animals, such as farmers and veterinarians, are most at risk for Q fever.

To better understand the risk of infection in veterinarians, Emory University public health researcher Ellen Whitney, MPH, and colleagues from the U.S. Centers for Disease Control and Prevention and the Georgia Department of Agriculture surveyed 508 U.S. veterinarians who attended an annual veterinarian conference in Hawaii in 2006. Blood samples from participating veterinarians were tested to detect antibodies against C. burnetii. The researchers also collected information about the veterinarians' working habits, work-related injuries, and history of protective clothing and equipment use.

Of the veterinarians surveyed, 22.2 percent had antibodies against Q fever bacteria in their blood, Whitney and colleagues found. Veterinarians more likely to have been exposed to the bacteria were generally older (46 years of age or older), worked near ponds, and treated cattle, pigs and wildlife.

"Physicians should consider the risk of infection with C. burnetii when treating ill veterinarians and others with potential occupational exposures," says Whitney, director of research projects at Emory's Rollins School of Public Health.

The disease and the bacteria that cause it were first identified in the late 1930s, when Australian scientists investigated an outbreak of unknown disease among abattoir workers. Since then, outbreaks have occurred among U.S. soldiers in Iraq and the disease has been reported worldwide with the exception of New Zealand. Last year saw the world’s largest ever recorded Q fever epidemic in The Netherlands, with more than 670 people affected by the disease.

Many people who are infected with the bacteria do not fall ill, but some experience flu-like symptoms, including headache, fever and a sore throat. In some cases chronic Q fever can develop months or years after initial exposure to the bacteria. For people with an existing heart condition, this can cause inflammation of the heart valves, known as endocarditis.

Whitney and colleagues conclude that veterinarians should use appropriate personal protective equipment when treating ill animals. Additionally, veterinarians and their physicians should be aware of the risk of infection. For those who have underlying heart disease or a suppressed immune system, and for pregnant women, quicker diagnosis of C. burnetii-related endocarditis will help to prevent complications, the researchers note.

Link to study online:
http://www.journals.uchicago.edu/doi/full/10.1086/596705

Ellen A. S. Whitney, MPH et al. Seroepidemiologic and occupational risk survey for Coxiella burnetii antibodies among US veterinarians. Clinical Infectious Diseases 2009:48 (1 March).

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The Robert W. Woodruff Health Sciences Center of Emory University is an academic health science and service center focused on missions of teaching, research, health care and public service. Its components include schools of medicine, nursing, and public health; Yerkes National Primate Research Center; the Emory Winship Cancer Institute; and Emory Healthcare, the largest, most comprehensive health system in Georgia. The Woodruff Health Sciences Center has a $2.3 billion budget, 17,000 employees, 2,300 full-time and 1,900 affiliated faculty, 4,300 students and trainees, and a $4.9 billion economic impact on metro Atlanta.

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