WA: Q Fever found in Grant County goats; 20 human cases in Washington and Montana

[Shiloh]

Source: http://www.columbiabasinherald.com/c...cc4c03286.html


Q Fever found in county, could be risky for humans
Posted: Tuesday, June 21, 2011 9:00 am | Updated: 3:53 pm, Fri Jun 17, 2011.

Q Fever found in county, could be risky for humans

EPHRATA - Grant County Health Officer Dr. Alexander Brzezny reported to the May 11 meeting of the Board of Health that several goats in the Moses Lake area have been found to have Q Fever.

He told the board Q Fever is potentially dangerous in humans and is hard to detect since symptoms are similar to influenza-like illness and tuberculosis.

According to Brzezny, there is a farm near Moses Lake with more than 100 show goats which have been experiencing difficulty with births. They've been tested for Q Fever and, so far, 16 percent have tested positive...

[Ronan Kelly]

Re: WA: Q Fever found in Grant County goats; could be risky for humans

June 23, 2011 in City
Human illnesses traced to goats
Moses Lake residents might have Q fever
By John Stucke The Spokesman-Review

Counties affected
Goats from the Grant County farms where Q fever originated also have been traced to Spokane, Adams, Pend Oreille, Walla Walla, Franklin, Clark, Thurston, Kittitas and Chelan counties. In addition, officials have traced infected goats to Cascade and Teton counties in Montana, where six people have been stricken with what is probably Q fever.

Five people in the Moses Lake area have been sickened, though not seriously, by what health officials suspect is a rare livestock-related bacterial infection called Q fever.

The infections have sparked a multiagency investigation by federal, state and local health and agricultural officials, who have now traced infected goats purchased from or bred at the quarantined farms in Grant County to nine other Washington counties, including Spokane County.

Officials also traced infected goats to Cascade and Teton counties in Montana, where another six people have been stricken with what is probably Q fever.

...

http://www.spokesman.com/stories/2011/jun/23/human-illnesses-traced-to-goats/

[Shiloh]

Re: WA: Q Fever found in Grant County goats; 11 suspected human cases in Washington and Montana

Source: http://seattletimes.nwsource.com/htm...writethru.html

Q fever goat disease spreads to humans

Health officials are working to contain a rare bacterial infection called Q fever that has spread from goats to humans and sickened at least 11 people in Washington and Montana.

By NICHOLAS K. GERANIOS

Associated Press

SPOKANE, Wash. ?

Health officials are working to contain a rare bacterial infection called Q fever that has spread from goats to humans and sickened at least 11 people in Washington and Montana.

The illness since May has stricken five people in the Moses Lake, Wash., area with flulike symptoms. Officials also have traced infected goats to Cascade and Teton counties in Montana, where six people have become ill, officials said Thursday...

[Ronan Kelly]

Re: WA: Q Fever found in Grant County goats; 11 suspected human cases in Washington and Montana

Foodborne Illness Outbreaks
Raw Milk in Michigan Linked to Q Fever
by Mary Rothschild | Jun 24, 2011

A Michigan woman endured prolonged hospitalization for Q-fever meningitis and two other women were also diagnosed with bacterial Q-fever infections after they drank unpasteurized milk from a farm in Livingston County, according to the Michigan Department of Community Health.


All three women, in their 30s and 40s, acknowledged obtaining raw milk from the farm as part of a herd share arrangement, according to a report in the Kalamazoo Gazette.


As a result of the three cases of Q fever, the Michigan health department of this week issued a warning about the dangers of consuming unpasteurized milk. Herd share schemes, in which participants pay for a share in a cow or goat in return for unpasteurized milk, are "not inspected or regulated under Michigan's dairy laws," the statement noted. Raw milk products are not permitted to be sold at retail in Michigan.
...

http://www.foodsafetynews.com/2011/06/raw-milk-in-michigan-causes-q-fever-outbreak/

[Gert van der Hoek]

Re: WA: Q Fever found in Grant County goats; 11 suspected human cases in Washington and Montana

The drinking of raw milk has been suggested as the source of recent Q-fever infections in the USA.

The typical Q-fever infection is airborne: inhalation of contaminated dust.

In the Netherlands with one of the largest documented Q-fever outbreaks in the world, several thousands of patients, not one patient was found to be infected orally.

In the USA and also in the Netherlands, UK or Danmark or Japan it is not uncommon to find the Coxiella Burnettii (= Q-fever)bacteria in milk. Upto 60% of the bulktank milk samples were positive in several surveys. Most of the bacteria are killed after pasteurisation.

Last year the CB bacteria was found in commercially available raw milk from the United States:

Foodborne Pathog Dis. 2010 Dec;7(12):1453-6. Epub 2010 Aug 12.

Detection of Coxiella burnetii in commercially available raw milk from the United States.

Loftis AD, Priestley RA, Massung RF.

Ross University School of Veterinary Medicine, Basseterre, St. Kitts.

Abstract
Unpasteurized (raw) milk can be purchased in 39 U.S. states, with direct consumer purchase for human consumption permitted in 29 of those 39 states.

Raw milk (n=21; cow, 14; goat, 7) was purchased in 12 states, and Coxiella burnetii, the agent of Q fever, was detected in 9 of 21 (42.9%) samples tested by polymerase chain reaction. Viability of the pathogen was demonstrated by isolation of the agent in tissue culture.

The demonstration of viable C. burnetii in commercially available raw milk poses a potential public health risk.


PubMed

Addtional research seems necessary to determine the route of infection. The 3 patients "got raw milk" . OK, some questions remain:

- they went to the farm them selves?
- what happenend during the process of buying the milk?
- weather conditions ?

So I am not convinced the infections were directly from consuming milk.

3 Sickened With Rare Infection From Raw Milk

June 23, 2011

LANSING (WWJ) - State health officials are warning of the dangers of drinking raw milk after three people were sickened with “Q fever.” All three said they got the raw milk from a Livingston County farm.

Two cases were reported in Washtenaw County and one in Monroe County. All three are women in their 30s or 40s.

Speaking to WWJ Newsradio 950, Providence Hospital Emergency room physician Dr. Steve McGraw says Q Fever is a rare but serious bacterial infection.

“The illness is signifficant. There is high fever, there’s body aches … muscle aches, a lot of joint pain, very poor appetite. Some people get what we call rigors, where there body is sort of shaking chills. Sometimes they have GI symptoms with it,” said McGraw.

McGraw said Q Fever also lead to other illnessed including pneumonia and heart infection.

One of the three women who fell ill with the disease was hospitalized with Q fever meningitis.

Read more - DetroitCBSlocal

[Emily]

Re: WA: Q Fever found in Grant County goats; 11 suspected human cases in Washington and Montana

In the Netherlands with one of the largest documented Q-fever outbreaks in the world, several thousands of patients, not one patient was found to be infected orally.

That's very significant research.

[Gert van der Hoek]

Re: WA: Q Fever found in Grant County goats; 20 human cases in Washington and Montana

Note: In Europe similar hygienic measures are taken to prevent spread of the Q-fever bacteria. In addition vaccination of diarygoats and dairysheep proved to be highly effective; even vaccination of infected herds.

See e.g. : Reduction of Coxiella burnetii Prevalence by Vaccination of Goats and Sheep, the Netherlands



Notes from the Field: Q Fever Outbreak Associated with Goat Farms --- Washington and Montana, 2011

October 14, 2011

On April 22, 2011, the Q fever bacterium Coxiella burnetii was detected in a goat placenta collected from a farm in Washington, where 14 of 50 (28&#37 pregnant does had aborted since January. A county health alert advised health-care providers to ask patients with symptoms compatible with Q fever (e.g., fever, headache, chills, and myalgia) about exposure to goats, and the owners of the farm informed purchasers of their goats that C. burnetii had been detected in their herd.

On May 25, the county health department reported a symptomatic patient with antibodies to C. burnetii who had purchased goats from the farm in February. On May 27, a report from Montana identified a child seropositive for C. burnetii whose family had purchased goats from the Washington farm in October 2010; one of the goats aborted triplets 2 weeks before the child's May 12, 2011, illness onset. On May 31, five more persons reported onset of symptoms compatible with Q fever from late March to mid-May, following exposure at a Montana farm to goats purchased from the Washington farm at various times during October 2010--January 2011. On June 10, the Washington State Department of Health and Montana Department of Public Health and Human Services requested CDC assistance to characterize the extent of the outbreak, distribute Q fever information, and identify others at risk for infection.

Goats sold after June 2010 by the Washington farm where C. burnettii initially was detected were traced to 21 farms in Washington (10 counties), Montana (three counties), and Oregon (one county). Seventeen farms participated in the outbreak investigation. C. burnetii infection was detected in 16 of 17 goat herds, including polymerase chain reaction confirmation of bacterial shedding in feces, vaginal mucous, or milk in 161 of 667 (24%) goats tested and an overall seroprevalence of 21% (131 of 615) by enzyme-linked immunosorbent assay.

To date, 19% (20 of 108; 11 in Washington and nine in Montana) of serologically tested persons met the outbreak case definition of a person epidemiologically linked to at least one farm of interest (i.e., as a goat owner, farm visitor, or neighbor) since January 2011 with a C. burnetii phase II immunoglobulin G titer ≥1:128 by immunofluorescence assay (1). No deaths were reported; four of the 20 persons were hospitalized, and five were asymptomatic.

Both states implemented a herd management plan to promote continued communication between public health and agricultural authorities and to advise goat owners to disinfect birthing areas, avoid contact with birth products, limit visitor access to animal holding areas, maintain an animal registry, and report animal abortions and positive Q fever test results to state authorities. All homes within a 1-mile radius of the Washington farm where C. burnetii was initially detected and a Montana farm that also had high goat seroprevalence linked to human illness were visited once by CDC or by county public health officials and CDC in July or August 2011 to provide Q fever health education and offer human serologic testing. The states have received no additional reports of Q fever since July.

Q fever (a category B bioterrorism agent) is a nationally notifiable disease in humans and is endemic throughout the United States with a national seroprevalence of 3% (2). Washington and Montana typically report ≤3 cases of Q fever annually. Acute Q fever is characterized by a self-limited febrile illness or, less often, by pneumonia or hepatitis. Less common still is chronic Q fever, which affects <5% of infected persons and presents as endocarditis in patients with preexisting valvular disease. Pregnant women, immunosuppressed persons, and patients with a preexisting heart-valve defect are at greatest risk for chronic Q fever.

Doxycycline is recommended for treatment of acute Q fever. C. burnetii is highly infectious, persists in the environment, and can travel for miles once windborne (3). Transmission can occur via inhalation of contaminated aerosols or dust; human-to-human transmission is rare. Cattle, sheep, and goats are the primary Q fever reservoirs. Continued community awareness is essential for disease prevention and control.

Additional information is available at http://www.cdc.gov/qfever.

CDC