Q fever is still an unknown disease

Between 2007 and 2010, between 50,000 and 100,000 Dutch people were infected. Thousands of people were ill in our country and unfortunately 95 people died from the effects of Q fever. Fortunately, this epidemic is just behind us. However, there are still many people who suffer from this unknown disease every day.

What is Q fever?

Q fever is an infectious disease that is transmitted from animal to human. Contamination does not therefore take place from person to person. Animals that have the bacteria with them cause the infection. In the Netherlands these are mainly contaminated dairy goats and sheep. Most people get this infectious disease by inhaling air where the bacterium is. The bacterium is called Coxiella Burnetii. The name Q fever comes from the name Query fever, which means question mark fever. This disease got this name because the cause of this disease was unknown for a long time.

Symptoms of Q fever

About 50% of people who have Q fever have no symptoms. They do not get sick. The other half of the people show a somewhat flu-like syndrome. Someone then suffers from:

  • Fever for a number of days, combined with annealing of the heat and then shivers of the cold.
  • Headache.
  • Dry cough.
  • Night sweats .
  • Painful muscles and joints.
  • Decreased appetite.

In some cases the disease is much more serious. The above symptoms are then supplemented with feeling very stuffy and having chest pain. It could be that someone gets pneumonia over it. The bacterium can also cause liver inflammation. This is characterized by: nausea, vomiting and diarrhea.

A very small percentage of people who are infected get a chronic infection. These people eventually get inflammation of the heart and blood vessels. These people then have chronic Q fever. This usually occurs in people who already had abnormalities in heart valves or in the large blood vessels. A previously experienced Q fever infection can also lead to chronic Q fever in pregnant women.

How can you become infected with Q fever?

The bacterium Coxiella Burnetii is the culprit. The bacteria is mainly in the amniotic fluid and the placenta of infected animals. This can be released during a birth from, for example, the placenta and amniotic fluid. In the Netherlands it is mainly infected sheep or goats that cause contamination. However, cows, dogs, cats, birds, ticks, lice and fleas can also cause contamination in humans. The bacteria can survive very well in the open air. Sometimes months to years. People who breathe air with the Q fever bacterium can get Q fever within 2 to 6 weeks after inhalation. The spreading is easy via the wind. Contamination does not take place by eating contaminated meat.

Risk groups

Some people are at greater risk of becoming infected with the Q fever bacterium. Those are:

  • People with reduced immune system due to a serious disease, including AIDS or cancer. These people often have a reduced resistance as a result of treatments and / or medication.
  • People with a heart defect (valve defect) or who have had surgery at their heart.
  • Pregnant women have an increased risk of becoming ill and also a slightly increased risk of premature birth or miscarriage.

Diagnosis Q fever

If the doctor thinks that there is Q fever, the diagnosis can be determined by means of a blood test. This blood test does or does not show antibodies against Q fever. On the basis of the presence of these antibodies and the quantity of these antibodies through time, it can be determined whether someone has contracted a Q fever infection.

When the diagnosis is made, the following additional tests can be done.

  • Echo of the heart 
    If the person has a heart defect, an echo of the heart will also be made. This echo can then show whether the Q fever bacteria caused an infection of the heart valves. In most cases, an ultrasound is not sufficient and a PET scan of the heart valves is also made.
  • Echo abdomen 
    If someone has chronic Q fever, an echo of the abdomen is often made. It is then assessed whether the large abdominal artery (aorta) is dilated. The Q-fever bacterium can cause infection of the aortic wall, especially if this blood vessel is dilated.
  • CT scan of the abdomen 
    Sometimes a CT scan of the abdomen is made if a person has chronic Q fever. This can also be used to assess whether the large abdominal artery (aorta) has been affected by the Q fever bacterium.

Treatment of Q fever

When someone has been diagnosed with Q fever, he or she will receive antibiotics for 2 weeks. The best antibiotic against Q fever is doxycycline. When someone has a reduced immune system, they receive an antibiotic course of 3 weeks. As with every antibiotic treatment, you also have to finish the cure here, even if you have no complaints. When someone continues to feel very sick, it is advised to take paracetamol. That may be 3 to 4 times 500 to 1000 mg per day.

Q Fever Fatigue Syndrome (QVS) 
Fortunately, most people recover from Q fever within 1 to 2 weeks. About 20% remain tired for a while after the fever period. When this fatigue lasts longer than a year after the acute infection, we speak of QVS. QVS stands for Q fever Fatigue Syndrome. Someone is very tired then. This fatigue can be accompanied by: muscle complaints, joint complaints and concentration problems.

All of this can have serious consequences for the quality of someone’s life. On his daily activities and work. Unfortunately, it is not yet clear whether an effective treatment exists for this.

When to the doctor with Q fever? 
It is wise to contact your doctor at the moment someone:

  • Feels very stuffy.
  • Feels that he or she becomes drowsy.
  • Everything that he or she drinks can not keep.
  • After 2 days of antibiotics, there is still no lower fever.


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