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Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

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  • Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Missouri Department of Health and Senior Services, Jefferson City, Missouri

Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated C. burnetii infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a C. burnetii phase II IgG titer ≥ 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3–5.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of C. burnetii on fomites within the community. A history of injection drug use was reported by 26/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.

Author Notes

* Address correspondence to Holly M. Biggs, Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333. E-mail: hbiggs@cdc.gov

Authors' addresses: Holly M. Biggs, Suzanne R. Todd, Kara Jacobs-Slifka, Naomi A. Drexler, Charles L. Evavold, Kelly A. Fitzpatrick, Rachael A. Priestley, Joseph Singleton, David Sun, Minh Tang, Cecilia Kato, Gilbert J. Kersh, and Alicia Anderson, CDC, Atlanta, GA, E-mails: hbiggs@cdc.gov, fww8@cdc.gov, ipf8@cdc.gov, isj3@cdc.gov, xka7@cdc.gov, hwm8@cdc.gov, rnp9@cdc.gov, jys7@cdc.gov, wnk3@cdc.gov, mltang@cdc.gov, hex0@cdc.gov, hws7@cdc.gov, and aha5@cdc.gov. George Turabelidze, Drew Pratt, Gail McCurdy, and Jennifer Lloyd, Missouri Department of Health and Senior Services, Jefferson City, MO, E-mails: george.turabelidze@health.mo.gov, drew.pratt@health.mo.gov, mccurg@lpha.mopublic.org, and jennifer.lloyd@health.mo.gov.

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