Q FEVER (Coxiella burnetii)
• Coxiella burnetii , an obligate intracellular gram-negative bacterium, is the causative agent of Q fever in humans and coxiellosis in animals. • Coxiella burnetii is highly contagious and environmentally resilient, with only small numbers of organisms required to infect humans. • Human infection is most commonly associated with exposure to animals at the time of parturition, particularly ruminants (primarily goats, cattle and sheep), however there is a growing awareness of the potential risk associated with periparturient companion animals.
ACAZAP RECOMMENDATIONS
• Exposure to periparturient animals is the biggest risk factor for pet-associated Q fever infection. Appropriate cleaning and disinfection of potentially contaminated areas is essential. Coxiella burnetii is a highly resilient organism and resistant to many disinfectants, heat and drying. Effective disinfectants include: 70% alcohol (30 min), hydrogen peroxide, and sodium hypochlorite (>5% solution). • Given that inhalation is the primary route of transmission, extreme care should be taken to avoid aerosolisation during the birthing process (e.g. when reviving puppies and kittens) and when cleaning potentially infectious areas. • Contaminated fabrics (e.g. drapes, towels, scrubs) should be autoclaved or disposed of via contaminated waste collection facilities. Standard washing and machine drying may result in aerosolisation. • Personal protective equipment consisting of disposable water- resistant gowns, gloves, P2/N95 masks and eye protection should be used during all reproductive procedures.
• Vaccination is available for at risk individuals >15 years of age and is highly recommended for all people likely to be exposed through lifestyle or occupation (including veterinarians, veterinary nurses, veterinary students, animal refuge workers, wildlife rehabilitators and professional dog and cat breeders). Due to the requirement for pre-vaccination testing for existing immunity (serology and skin test), vaccination may not be available from all medical practitioners. A list of registered vaccinators can be found at www.qfever.org. • Individuals at greater risk of severe consequences from infection (e.g. pregnant women, immunocompromised individuals and individuals with valvular disease) should avoid contact with periparturient and neonatal dogs and cats. • Education for dog and cat breeders on the risks and their mitigation, such as the use of dedicated birthing areas away from household facilities and vaccination as per the Australian Immunisation Handbook is important.
IN ANIMALS
AETIOLOGY AND EPIDEMIOLOGY • Coxiella burnetii is an obligate intracellular gram- negative bacterium with a life cycle that includes two distinct morphological and functional forms. The “large-cell variant” is the metabolically active intracellular form and the “small-cell variant” is the inactive extracellular pseudo- sporulated form that is highly environmentally resilient and transmits the infection between hosts.
• Dogs and cats are likely exposed through inhalation of organisms from close contact with parturient animals and birth products or other contaminated body secretions. • Ingestion of contaminated meat from reservoir species is a potential route of infection in dogs and cats. Coxiella DNA has been detected in commercially available kangaroo meat, however whether this represents viable organisms, and if so what role it may play in the transmission to dogs and cats (and humans), is unclear. 1 Feeding raw kangaroo is a risk factor
CONTENTS
63 Companion Animal Zoonoses Guidelines
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