Q Fever
https://www.cdc.gov/qfever/index.html
Q fever is a disease caused by the bacteria Coxiella burnetii. This bacteria naturally infects some animals, such as goats, sheep, and cattle. C. burnetii bacteria are found in the birth products (i.e. placenta, amniotic fluid), urine, feces, and milk of infected animals. People can get infected by breathing in dust that has been contaminated by infected animal feces, urine, milk, and birth products. Some people never get sick; however, those who do usually develop flu-like symptoms including fever, chills, fatigue, and muscle pain.
Bioterrorism
A biological attack, or bioterrorism, is the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops.
C. burnetii, the bacteria that causes Q fever, has been described as a potential bioterrorism agent.
C. burnetii is a select agent subject to the select agentexternal icon regulations found in 42 CFR Part 73.
C. burnetii is a highly infectious agent, in some cases requiring less than 10 bacteria to make you sick.
C. burnetii is extremely resistant to heat, drying, and many common disinfectants.
People get infected by breathing in contaminated dust.
C. burnetii has been previously weaponized for use in biological warfare and is considered a potential terrorist threat.
We do not know if or when a bioterrorism attack might occur. However, federal agencies have worked for years with health departments across the country to plan and prepare for any such attack.
Considerations for Intentional Release
C. burnetii is a highly infectious agent that is resistant to heat, drying, and many common disinfectants.It can be aerosolized and inhalation is the primary route of infection for people.
As few as 1-10 C. burnetii organisms may cause disease in a susceptible person.This agent has been previously weaponized for use in biological warfare and is considered a potential terrorist threat.
The World Health Organization has estimated that if 50 kg of C. burnetii were aerosolized over an urban area with 500,000 inhabitants, there would be 125,000 cases of acute illness, 9,000 cases of chronic Q fever, and 150 fatalities (Health aspects of chemical and biological weapons, 1st edition, 1970External).
Person to person transmission is possible via transplacental exposure, sexual contact, blood transfusion, and transplantation.
Nosocomial infections have been rarely reported following autopsies and obstetrical procedures involving infected persons. (For more information on Occupational Exposure and Prevention relating to Q fever see the CDC’s MMWR Diagnosis and Management of Q fever—United States, 2013)
Clusters of pneumonia, or unusual clusters of acute febrile illness with respiratory involvement or granulomatous hepatitis, in a community where no other cause can be identified may indicate a possible intentional release of C. burnetii.
In cases of suspected intentional release, post exposure prophylaxis (doxycycline 100 mg twice a day for 5-7 days) can be considered in groups determined to be at high risk for exposure, but is not recommended for the prevention of naturally occurring Q fever.
Chemoprophylaxis is only considered effective if administered within 8-12 days of exposure.