Q fever

Caused by Coxiella burnetii manifested by flu like illness, atypical pneumonia, and hepatitis.

Diagnosis bases on serologic test with seroconversion between acute and convalescent samples or presence of anti-C burnetii IgM antibody.

Sheep are main reservoir from which human contamination occurs.

Airborne infection acquired by inhaling dust and aerosols contaminated by infected animals, usually cattle, sheep or goats.

Endemic in Iraq.

Direct contact with infected animals or ingestion of contaminated dairy products usually does not cause infection.

Human-human transmission via sexual activity occurs rarely.

Some infections may be asymptomatic but most patients present with unexplained fever, and sometimes with pneumonia or hepatitis.

Symptoms usually begin 2-3 weeks after exposure.

Most patients recover spontaneously within a few weeks.

Treatment with doxycycline can reduce duration of the illness and decrease complication risks.

Fewer than 1% of patients progress to a chronic illness, and patients with preexisting heart valve disease, pregnancy, or who are immunosuppressed are at higher risk.

Doxycycline 100 mg BID for 2-3 weeks is treatment for acute illness.

Diagnosis for acute infection is by serologic evidence of a fourfold increase in IgG phase 2 antibody by immunofluorescence assay between paired serum samples taken 2-4 weeks apart.

Serodiagnosis by IgM antibodies alone can lead to false positive results.

Neurological manifestations are rare and usually transient.

Endemic in Croatia.

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