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Q fever as a biological weapon.

Frank T Kagawa1, John H Wehner, Vibha Mohindra

  • 1Santa Clara Valley Medical Center, San Jose, CA 95128, USA. Frank.Kagawa@hhs.co.santa-clara.ca.us

Seminars in Respiratory Infections
|September 25, 2003
PubMed
Summary

Q fever, a bacterial zoonosis caused by Coxiella burnetii, is highly infectious but typically causes mild illness. Doxycycline is the recommended treatment for acute and chronic Q fever, including endocarditis.

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Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Zoonoses

Background:

  • Q fever is a bacterial zoonosis caused by Coxiella burnetii, an intracellular coccobacillus.
  • Coxiella burnetii is highly infectious, with potential for biowarfare applications.
  • Most infections result in asymptomatic seroconversion, but acute and chronic manifestations can occur.

Purpose of the Study:

  • To summarize the epidemiology, clinical manifestations, diagnosis, and treatment of Q fever.
  • To provide guidance on antibiotic therapy for acute and chronic Q fever.
  • To address treatment and prophylaxis strategies in mass casualty scenarios.

Main Methods:

  • Diagnosis is primarily based on serology due to the hazardous nature of culturing Coxiella burnetii.
  • Tetracyclines, particularly doxycycline, are the antibiotics of choice.
  • Treatment durations vary: 14–21 days for typical acute cases, 5–7 days for mass casualty prophylaxis/therapy, and 18 months with hydroxychloroquine for chronic endocarditis.

Main Results:

  • Acute Q fever presents with nonspecific febrile illness, pneumonia, hepatitis, or neurologic symptoms.
  • Chronic Q fever can lead to endocarditis, hepatitis, or chronic fatigue syndrome.
  • Doxycycline is effective for acute Q fever therapy and prophylaxis, while prolonged doxycycline with hydroxychloroquine is the best therapy for chronic Q fever.

Conclusions:

  • Q fever requires prompt diagnosis and appropriate antibiotic treatment.
  • Doxycycline is a cornerstone therapy for Q fever, with specific regimens for different clinical scenarios.
  • Effective management strategies are crucial for both individual patients and public health in potential biowarfare events.

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