Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de Méditerranée, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
Vet Microbiol. 2010 Jan 27;140(3-4):297-309. doi: 10.1016/j.vetmic.2009.07.016. Epub 2009 Aug 8.
Q fever is a zoonotic disease caused by the ubiquitous pathogen Coxiella burnetii responsible for acute and chronic clinical manifestations. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. This illness is associated with a wide clinical spectrum, from asymptomatic or mildly symptomatic seroconversion to fatal disease. In humans Q fever can manifest as an acute disease (mainly as a self-limited febrile illness, pneumonia, or hepatitis) or as a chronic disease (mainly endocarditis), especially in patients with previous valvulopathy and to a lesser extent in immunocompromised hosts and in pregnant women. In contrast in animals, Q fever is in most cases, strikingly asymptomatic. The definite diagnosis of Q fever is made based on a significant increase in serum antibody titers, the determination of which often requires considerable time, and therefore patients must be monitored for a certain period. The treatment is effective and well tolerated, but must be adapted to the acute or chronic pattern with the tetracyclines to be considered the mainstay of antibiotic therapy. Several actions have been proposed to prevent and reduce the animal and environmental contamination. Vaccination of animals in infected flocks, as well as in uninfected ones close to them, with an efficient vaccine can prevent abortions and shedding of the bacteria.
Q 热是一种由无处不在的病原体贝纳柯克斯体引起的人畜共患病，可导致急性和慢性临床症状。农场动物和宠物是主要的感染源，人类感染主要通过吸入受污染的气溶胶来实现。这种疾病与广泛的临床谱相关，从无症状或轻度症状的血清转化到致命疾病。在人类中，Q 热可表现为急性疾病（主要为自限性发热疾病、肺炎或肝炎）或慢性疾病（主要为心内膜炎），特别是在有先前瓣膜病的患者中，在免疫功能低下的宿主和孕妇中则较少见。相比之下，在动物中，Q 热在大多数情况下明显无症状。Q 热的明确诊断基于血清抗体滴度的显著升高，确定这一点通常需要相当长的时间，因此必须在一定时间内监测患者。治疗有效且耐受性良好，但必须根据急性或慢性模式进行调整，四环素被认为是抗生素治疗的主要药物。已经提出了几种预防和减少动物和环境污染的措施。用有效的疫苗对感染羊群中的动物以及附近未感染的动物进行免疫接种，可以预防流产和细菌的脱落。
