17883 Q Fever

Overview

Q fever is a bacterial infection that you can catch from farm animals, most commonly sheep, goats, and cattle. It is caused by a type of bacteria called Coxiella burnetii, and it usually causes a flu-like illness. Most people get better completely, but it can occasionally cause long-term health problems if not treated.

Q fever is uncommon in most countries. It appears in small outbreaks, often in farming communities. It is more common in rural areas with livestock.

People most likely to get Q fever are those who work with animals: farmers, farm workers, veterinarians, animal health workers, and people who work in abattoirs or with animal products. It can affect anyone, but these occupations carry the highest risk.

Symptoms

Common symptoms

• High fever (often up to 104°F/40°C or more)
• Shaking chills and heavy sweating
• Severe headache, often at the front of the head
• Muscle aches and joint pains
• Feeling very tired and weak
• Nausea, vomiting, or diarrhoea
• A dry cough or mild chest discomfort
• Loss of appetite

Causes

Main causes

• Infection with the bacterium Coxiella burnetii.
• The bacteria are breathed in from the air – for example, dust contaminated with animal birth products, faeces, or urine.
• Drinking unpasteurised (raw) milk or dairy products from infected animals can also carry the bacteria.
• Direct contact with infected animals, especially during lambing or calving, is another route.

Risk factors

• Working on a farm or with livestock
• Being a vet, vet nurse, or animal assistant
• Working in an abattoir, wool or hide processing, or animal research
• Living on a farm or near fields where sheep or goats graze
• Drinking raw, unpasteurised milk
• Having a weakened immune system (for example, from a medical condition or treatment)

When to see a doctor

See a doctor urgently if:

• Any of the emergency symptoms listed above – call your local emergency number right away.
• A fever that keeps coming back or does not improve after a few days.
• Severe headache that is not relieved by usual painkillers (ask your pharmacist what is safe for you).

Book a routine appointment if:

• If you have been in contact with farm animals – especially during birthing – and develop any flu-like symptoms, make an appointment with your GP.
• If you have a persistent cough, weight loss, or night sweats, see a doctor.
• If you are pregnant and have had a possible exposure, seek advice even if you feel well.

Diagnosis

Your doctor will ask about your symptoms and any contact you have had with farm animals. Because Q fever can look like other illnesses such as flu, the main way to confirm it is with a blood test.

Tests that may be done

• Blood test for Q fever antibodies (serology)
• PCR test on blood to detect the bacteria directly, especially in the early days
• Sometimes a chest X-ray if you have a cough or chest pain
• If the infection might be chronic, further scans or an ultrasound of your heart may be recommended in a specialist clinic

What to expect at your appointment

Your doctor will take a small sample of blood from your arm and send it to a laboratory. Results may take a few days to a few weeks, depending on the type of test. While you wait, you can treat your symptoms with plenty of fluids and rest. If you are very unwell, you may be referred to hospital for monitoring and treatment.

Treatment

Q fever is treated with antibiotics. For most people, a short course will clear the infection. People who develop chronic Q fever (a long-lasting infection) need a much longer course of antibiotics, sometimes for 18 months or more, under the care of a specialist.

Self-care at home

• Rest – your body is fighting an infection.
• Drink plenty of water and clear fluids to stay well hydrated.
• Use a thermometer to keep an eye on your temperature. Paracetamol or ibuprofen can help with fever and aches – ask your pharmacist or doctor which is safe for you.
• If you have a cough and are breathing comfortably, simple honey and warm drinks can soothe your throat – but check with your doctor if you are diabetic or have other conditions.

Medical treatments

Your doctor will prescribe an appropriate antibiotic taken by mouth. It is important to finish the full course exactly as prescribed, even if you start to feel better. For more severe cases, you might need to stay in hospital for intravenous antibiotics and fluids. For chronic Q fever, a specialist team will plan your long-term treatment. Never share or reuse antibiotics, and always take them under medical advice.

Living with this condition

For the first few weeks, you may feel tired and unwell. Plan your days to include extra rest. Go back to work or school gradually, and listen to your body. If you are recovering from a chronic infection, keep up with your follow-up appointments.

Lifestyle tips

• Take time off work until you are feeling well – your doctor can give you a sick note if needed.
• Avoid strenuous exercise until you have more energy.
• If you live on a farm, during recovery wear appropriate protective clothing when around animals to avoid getting re-infected (though immunity is usually lifelong).
• Keep good hand hygiene, especially after touching animals or animal products.

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and protein to help your immune system. Gentle activities like short walks are fine when you feel up to it. Don’t push yourself until you are fever-free and your energy has returned.

Mental health and emotional wellbeing

A prolonged infection can feel draining and frustrating. You may feel low, anxious about your health, or isolated if you are off work. These feelings are normal. Talk to your doctor if you are struggling, and consider reaching out to a mental health service such as a local counselling service.

Prevention

Yes, you can reduce your risk of Q fever by being careful around farm animals. The most important step is to avoid breathing in dust or droplets from animal birth areas. Wear a mask and gloves when helping with lambing or calving, and wash your hands thoroughly afterwards. Pasteurise or heat milk and dairy products before drinking. If you are pregnant, it is especially important to avoid helping with animal births and to stay away from birthing pens.

Vaccines

There is a Q fever vaccine available in some countries (such as Australia), but it is not routinely recommended in the UK. Vaccination may be offered to people at very high risk after an assessment. Ask your occupational health service or doctor whether this is available in your area.

Screening programmes

Routine screening for Q fever is not recommended for the general public. Blood tests are used when someone has symptoms or a known high-risk exposure. In some workplaces with livestock contact, regular testing may happen – check with your employer.

Complications

If left untreated

• If the infection goes untreated, it can become a chronic condition, which means the bacteria stay in the body for months or years.
• Chronic Q fever most often affects the heart (endocarditis – infection of the inner lining and valves of the heart), but can also affect the liver, blood vessels, or bones.
• In rare cases, an untreated acute infection can cause pneumonia (lung infection) or hepatitis (liver inflammation).
• Women who are pregnant and get Q fever have a higher risk of miscarriage or stillbirth, so early treatment is vital.

Long-term outlook

For most people, Q fever is a short-term illness that gets better completely with treatment. Even chronic Q fever, though serious, can be managed effectively with a long course of antibiotics under specialist care. With proper diagnosis and follow-up, most people go on to live normal, healthy lives.

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