Assessing the evidence for effective biosafety risk management in Coxiella burnetii research

Coxiella burnetii, the causative agent of Q fever, is a highly infectious zoonotic bacterium presenting significant biosafety challenges, particularly in laboratory environments. Due to its low infectious dose, environmental resilience, and potential for aerosol transmission, C. burnetii has been classified as a Risk Group 3 pathogen and Category B biothreat agent. This review evaluates the biosafety practices required for safe handling, including adherence to Biosafety Level 3 (BSL-3) containment for propagative work and BSL-2 standards for diagnostic activities. Strategies such as vaccination, personal protective equipment (PPE), environmental controls, and rigorous decontamination protocols are critical to mitigate laboratory-acquired infections (LAIs). Historical reports highlight C. burnetii as a leading cause of LAIs, underscoring the importance of implementing risk-based biosafety frameworks outlined by the World Health Organization. However, gaps remain in disinfection efficacy data, vaccine accessibility, and consistent application of biosafety measures, particularly in resource-limited settings. Addressing these challenges through enhanced surveillance, interdisciplinary research, and improved access to preventive tools can reduce C. burnetii-associated risks. This review emphasises the need for adaptive, sustainable practices to ensure global laboratory safety and highlights the integration of evidence-based strategies for C. burnetii research.