Editing Q fever (section)

==Epidemiology==
[[Image:Coxiella burnetii 01.JPG|thumb|right|''C. burnetii'', the Q fever-causing agent]]

Q fever is a globally distributed [[Zoonosis|zoonotic disease]] caused by a highly sustainable and virulent bacterium. The pathogenic agent is found worldwide, with the exception of New Zealand<ref name="pmid171479572">{{cite journal |vauthors=Cutler SJ, Bouzid M, Cutler RR |date=April 2007 |title=Q fever |journal=The Journal of Infection |volume=54 |issue=4 |pages=313–318 |doi=10.1016/j.jinf.2006.10.048 |pmid=17147957}}</ref> and Antarctica.<ref name="Salifu-2019">{{Cite journal |last1=Salifu |first1=Samson Pandam |last2=Bukari |first2=Abdul-Rahman Adamu |last3=Frangoulidis |first3=Dimitrios |last4=Wheelhouse |first4=Nick |date=2019-05-01 |title=Current perspectives on the transmission of Q fever: Highlighting the need for a systematic molecular approach for a neglected disease in Africa |url=https://www.sciencedirect.com/science/article/pii/S0001706X19300889 |journal=Acta Tropica |volume=193 |pages=99–105 |doi=10.1016/j.actatropica.2019.02.032 |pmid=30831112 |s2cid=73461378 |issn=0001-706X}}</ref>  Understanding the transmission and risk factors of Q fever is crucial for public health due to its potential to cause widespread infection.

Recent data indicates that Q fever remains a significant public health concern worldwide. In 2019, the United States reported 178 acute Q fever cases and 34 chronic cases. Notably, in 2024, the state of Victoria, Australia, experienced a marked increase in Q fever cases, with 77 reported instances—a significant rise compared to the previous five years. This surge prompted health authorities to issue alerts emphasizing the importance of preventive measures and awareness.<ref>{{Cite web |last=CDC |date=2024-05-20 |title=Epidemiology and Statistics |url=https://www.cdc.gov/q-fever/data-research/index.html?utm_source=chatgpt.com |access-date=2025-03-23 |website=Q Fever |language=en-us}}</ref>

===Transmission and occupational risks===
Transmission primarily occurs through the inhalation of contaminated dust, contact with contaminated milk, meat, or wool, and particularly birthing products. [[Ticks]] can transfer the [[pathogen]]ic agent to other animals. While human-to-human transmission is rare, often associated with the transmission of birth products, sexual contact, and blood transfusion,<ref name="Salifu-2019" /> certain occupations pose higher risks for Q fever:<ref>{{Cite web |title=Q fever: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/000611.htm |url-status=live |archive-url=https://web.archive.org/web/20160728022742/https://medlineplus.gov/ency/article/000611.htm |archive-date=2016-07-28 |access-date=2018-04-17 |website=[[MedlinePlus]] |language=en}}</ref>

* [[Veterinary]] personnel
* [[Feedlot|Stockyard]] workers
* [[Farmer]]s
* [[Sheep shearer]]s
* Animal transporters
* Laboratory workers handling potentially infected veterinary samples or visiting [[abattoir]]s
* People who cull and process [[kangaroos]]
* Hide ([[Tanning (leather)|tannery]]) workers

It is important to note that anyone who has contact with animals infected with Q fever bacteria, especially people who work on farms or with animals, is at an increased risk of contracting the disease.<ref name="CDC-2021">{{Cite web |last=CDC |date=2021-08-06 |title=Q fever epidemiology and statistics {{!}} CDC |url=https://www.cdc.gov/qfever/stats/index.html |access-date=2023-11-21 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> Understanding these occupational risks is crucial for public health.

===Prevalence and risk factors===
Studies indicate a higher prevalence of Q fever in men than in women,<ref name="pmid105899062">{{cite journal |vauthors=Domingo P, Muñoz C, Franquet T, Gurguí M, Sancho F, Vazquez G |date=October 1999 |title=Acute Q fever in adult patients: report on 63 sporadic cases in an urban area |journal=Clinical Infectious Diseases |volume=29 |issue=4 |pages=874–879 |doi=10.1086/520452 |pmid=10589906 |doi-access=free}}</ref><ref name="pmid33017082">{{cite journal |vauthors=Dupuis G, Petite J, Péter O, Vouilloz M |date=June 1987 |title=An important outbreak of human Q fever in a Swiss Alpine valley |journal=International Journal of Epidemiology |volume=16 |issue=2 |pages=282–287 |doi=10.1093/ije/16.2.282 |pmid=3301708}}</ref> potentially linked to occupational exposure rates.<ref name="CDC20202">{{Cite web |date=2019-09-16 |title=Epidemiology and Statistics {{!}} Q Fever {{!}} CDC |url=https://www.cdc.gov/qfever/stats/index.html |url-status=live |archive-url=https://web.archive.org/web/20200529130025/https://www.cdc.gov/qfever/stats/index.html |archive-date=2020-05-29 |access-date=2020-05-27 |website=www.cdc.gov |language=en-us}}</ref> Other contributing risk factors include geography, age, and occupational exposure. Diagnosis relies on [[blood compatibility testing]], with treatment varying for acute and chronic cases. Acute disease often responds to [[doxycycline]], while chronic cases may require a combination of [[doxycycline]] and [[hydroxychloroquine]].<ref>{{Cite journal |last1=Hartzell |first1=Joshua D. |last2=Wood-Morris |first2=Robert N. |last3=Martinez |first3=Luis J. |last4=Trotta |first4=Richard F. |date=May 2008 |title=Q Fever: Epidemiology, Diagnosis, and Treatment |journal=Mayo Clinic Proceedings |volume=83 |issue=5 |pages=574–579 |doi=10.4065/83.5.574 |issn=0025-6196|doi-access=free |pmid=18452690 }}</ref> It is worth noting that Q fever was officially reported in the United States as a notifiable disease in 1999 due to its potential biowarfare agent status.<ref name="Patil-2023">{{Citation |last1=Patil |first1=Sachin M. |title=Q Fever |date=2023 |url=http://www.ncbi.nlm.nih.gov/books/NBK556095/ |work=StatPearls |access-date=2023-11-21 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32310555 |last2=Regunath |first2=Hariharan}}</ref>

Q fever exhibits global epidemiological patterns, with higher incidence rates reported in certain countries. In Africa, wild animals in rainforests primarily transmit the disease, making it [[Endemic (epidemiology)|endemic]].<ref name="Salifu-2019" /> Unique patterns are observed in Latin America, but reporting is sporadic and inconsistent between and among countries, making it difficult to track and address.<ref>{{Cite journal |last1=Fernandes |first1=Jorlan |last2=Sampaio de Lemos |first2=Elba Regina |date=2023-04-01 |title=The multifaceted Q fever epidemiology: a call to implement One Health approach in Latin America |journal=The Lancet Regional Health - Americas |volume=20 |pages=100463 |doi=10.1016/j.lana.2023.100463 |issn=2667-193X |pmc=10006848 |pmid=36915670}}</ref>

Recent outbreaks in European countries, including the Netherlands and France, have been linked to urbanized [[goat farming]], raising concerns about the safety of intensive [[livestock]] farming practices and the potential risks of zoonotic diseases. Similarly, in the United States, Q fever is more common in livestock farming regions, especially in the West and the Great Plains. California, Texas, and Iowa account for almost 40% of reported cases, with a higher incidence during the spring and early summer when livestock are breeding, regardless of whether the infection is acute or chronic.<ref name="CDC-2021" />

These outbreaks have affected a significant number of people, with immunocompromised individuals being more severely impacted.<ref name="Patil-2023" /> The global nature of Q fever and its association with livestock farming highlight the importance of implementing measures to prevent and control the spread of the disease, particularly in high-risk regions.

===Age and occupational exposure===
Older men in the West and Great Plains regions, involved in close contact with livestock management, are at a higher risk of contracting chronic Q fever.<ref name="CDC20202" /> This risk may be further increased for those with a history of cardiac problems.<ref name="CDC20202" /> The disease can manifest years after the initial infection, presenting symptoms such as non-specific fatigue, fever, weight loss, and [[endocarditis]].<ref name="Salifu-2019" /><ref name="CDC20202" /> Additionally, certain populations are more vulnerable to Q fever, including children living in farming communities, who may experience similar symptoms as adults.<ref>{{Cite journal |last1=Bwatota |first1=Shedrack Festo |last2=Cook |first2=Elizabeth Anne Jessie |last3=de Clare Bronsvoort |first3=Barend Mark |last4=Wheelhouse |first4=Nick |last5=Hernandez-Castor |first5=Luis E |last6=Shirima |first6=Gabriel Mkilema |date=2022-11-17 |title=Epidemiology of Q-fever in domestic ruminants and humans in Africa. A systematic review |journal=CABI One Health |language=en |doi=10.1079/cabionehealth.2022.0008 |s2cid=253662234 |issn=2791-223X|doi-access=free |hdl=20.500.11820/8b572652-80f8-4983-a0f0-c2586c7d1b9e |hdl-access=free }}</ref> There have also been reported cases of Q fever among United States military service members,<ref>{{cite web |last1=Anderson |first1=Alicia D. |last2=Smoak |first2=Bonnie |last3=Shuping |first3=Eric |last4=Ockenhouse |first4=Christopher |last5=Petruccelli |first5=Bruno |title=Q Fever and the US Military - Volume 11, Number 8—August 2005 - Emerging Infectious Diseases journal - CDC |url=https://wwwnc.cdc.gov/eid/article/11/8/05-0314_article |language=en-us |doi=10.3201/eid1108.050314|pmid=16110586 }}</ref> particularly those deployed to Iraq or Afghanistan, which further highlights the importance of understanding and addressing the occupational risks associated with Q fever.<ref>{{Cite journal |last=Hartzell |first=Joshua |date=May 2008 |title=Q Fever: Epidemiology, Diagnosis, and Treatment |journal=Concise Review for Physicians |volume=83 |issue=5 |pages=574–579|doi=10.4065/83.5.574 |pmid=18452690 }}</ref>

===Prevention and public health education===
Proper public health education is crucial in reducing the number of Q fever cases. Raising awareness about transmission routes, occupational risks, and preventive measures,<ref name="Patil-2023"/> such as eliminating unpasteurized milk products from the diet, can help prevent the spread of disease.<ref>{{Cite web |author=((CDC))|date=2019-01-15 |title=Prevention of Q fever {{!}} CDC |url=https://www.cdc.gov/qfever/prevention/index.html |access-date=2023-12-12 |website=Centers for Disease Control and Prevention |language=en-us}}</ref>

Interdisciplinary collaboration between medical personnel and farmers is critical when developing strategies for control and prevention in a community.<ref name="Ullah-2022">{{Cite journal |last1=Ullah |first1=Qudrat |last2=Jamil |first2=Tariq |last3=Saqib |first3=Muhammad |last4=Iqbal |first4=Mudassar |last5=Neubauer |first5=Heinrich |date=2022-07-28 |title=Q Fever—A Neglected Zoonosis |journal=Microorganisms |volume=10 |issue=8 |pages=1530 |doi=10.3390/microorganisms10081530 |issn=2076-2607 |pmc=9416428 |pmid=36013948 |doi-access=free }}</ref> Awareness campaigns should particularly target occupations that work with livestock, focusing on risk-reduction procedures such as herd monitoring, implementing sanitation practices and [[personal protective equipment]], and vaccinating animals.<ref name="Ullah-2022" /> Locating livestock farms at least 500 meters away from residential areas can also help reduce animal-to-human transmission.<ref name="Ullah-2022" />