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{{CMG}}
{{CMG}}
{{Q fever}}
{{Q fever}}
==Overview==
==Overview==
Q fever is a disease caused by C. brutenii, an intracellular gram-negative  proteobacterium. The disease can have a wide range of clinical presentations and affect many organ systems due to the unique virulence factors of the organism.
Q fever is a disease caused by [[Coxiella burnetii|C. brutenii]], an intracellular [[gram-negative]] proteobacterium. The disease can have a wide range of clinical presentations and affect many organ systems due to the unique [[virulence factors]] of the [[organism]].


==Pathophysiology==
==Pathophysiology==
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*Vertical (mother to fetus) transmission has been reported
*Vertical (mother to fetus) transmission has been reported
*Parentral
*Parentral
*Through tick bites
*Through [[tick bites]]
   
   
===Pathogenesis:===
===Pathogenesis:===
   
   
C. Brutenii has the ability to exist in 2 forms:
[[Coxiella burnetii|C. Brutenii]] has the ability to exist in 2 forms:
   
   
====Small cell form:<ref name="urlDiagnosis of Q Fever">{{cite web |url=http://jcm.asm.org/content/36/7/1823.short |title=Diagnosis of Q Fever |format= |work= |accessdate=}}</ref>====
====Small cell form:<ref name="urlDiagnosis of Q Fever">{{cite web |url=http://jcm.asm.org/content/36/7/1823.short |title=Diagnosis of Q Fever |format= |work= |accessdate=}}</ref>====
Often described as the spore form of C. Brutenii
Often described as the spore form of [[Coxiella burnetii|C. Brutenii]]
Resists the external environmental factors as heat, pressure and dissinfectants for long periods
Resists the external environmental factors as heat, pressure and disinfectants for long periods
   
   
====Large cell form:====
====Large cell form:====
The active form of the organism
The active form of the [[organism]]
Large cell form persists in the macrophages inside acidic vacuoles.
Large cell form persists in the [[macrophages]] inside acidic vacuoles.
   
   
*Small and large cell forms are antigenically different and this plays a role in the virulence of the organism.
*Small and large cell forms are [[Antigen|antigenically different]] and this plays a role in the [[virulence]] of the [[organism]].
*The genome of C. Brutenii has been analyzed in 1995. Multiple genes encoding for Na/ ion proton exchanger have been discovered and this explains the ability of the organism to survive in low PH.
*The [[genome]] of [[Coxiella burnetii|C. Brutenii]] has been analyzed in 1995. Multiple [[genes]] encoding for Na/ ion proton exchanger have been discovered and this explains the ability of the organism to survive in [[PH|low PH]].
   
   
The infection has 2 phases that correlate with changes in the lipopolysaccharide of C. Brutenii:<ref name="pmid1489455">{{cite journal |vauthors=Choyce DP |title=Anterior chamber lens exchange |journal=J Cataract Refract Surg |volume=18 |issue=5 |pages=537 |year=1992 |pmid=1489455 |doi= |url=}}</ref>
The infection has 2 phases that correlate with changes in the [[lipopolysaccharide]] of [[Coxiella burnetii|C. Brutenii]]:<ref name="pmid1489455">{{cite journal |vauthors=Choyce DP |title=Anterior chamber lens exchange |journal=J Cataract Refract Surg |volume=18 |issue=5 |pages=537 |year=1992 |pmid=1489455 |doi= |url=}}</ref>
**Phase I: characterized by smooth lipopolysaccharide capsule. Despite being less efficient in the invasion of host cells, antibodies against phase I is always isolated from acute Q fever patients.  
**Phase I: characterized by smooth [[lipopolysaccharide]] capsule. Despite being less efficient in the invasion of host cells, [[antibodies]] against phase I is always isolated from acute Q fever patients.  
**Phase II: characterized by rough lipopolysaccharide capsule and antibodies against phase II have been isolated from chronic Q fever patients.
**Phase II: characterized by rough [[lipopolysaccharide]] capsule and [[antibodies]] against phase II have been isolated from chronic Q fever patients.


===Q fever as a biological weapon:===
===Q fever as a biological weapon:===
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*Q-fever is category "B" agent. It is highly contagious and very stable in aerosols in a wide range of temperatures.  
*Q-fever is category "B" agent. It is highly contagious and very stable in aerosols in a wide range of temperatures.  
*Just 1-2 particles are enough to infect an individual.  
*Just 1-2 particles are enough to infect an individual.  
*Q-fever microorganisms may survive on surfaces up to 60 days (like sporulating bacteria).
*Q-fever [[microorganisms]] may survive on surfaces up to 60 days (like sporulating bacteria).
*According to WHO estimates<ref name="urlapps.who.int">{{cite web |url=http://apps.who.int/iris/bitstream/10665/39444/1/24039.pdf |title=apps.who.int |format= |work= |accessdate=}}</ref>, an amount of 50 kg of  C. Brutenii if spread in an area of 2 square kilometers is capable of:
*According to [[WHO]] estimates<ref name="urlapps.who.int">{{cite web |url=http://apps.who.int/iris/bitstream/10665/39444/1/24039.pdf |title=apps.who.int |format= |work= |accessdate=}}</ref>, an amount of 50 kg of  [[Coxiella burnetii|C. Brutenii]] if spread in an area of 2 square kilometers is capable of:
:*Infecting 500,000 humans
:*Infecting 500,000 humans
:*Killing 150 individuals
:*Killing 150 individuals
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==Microscopic pathology:==
==Microscopic pathology:==
   
   
*C. Brutenii is a gram negative polymorphic intracellular organism.<ref name="urlQ Fever on JSTOR">{{cite web |url=http://www.jstor.org/stable/4458369?seq=1#page_scan_tab_contents |title=Q Fever on JSTOR |format= |work= |accessdate=}}</ref>
*[[Coxiella burnetii|C. Brutenii]] is a [[gram negative]] polymorphic [[Intracellular|intracellular organism]].<ref name="urlQ Fever on JSTOR">{{cite web |url=http://www.jstor.org/stable/4458369?seq=1#page_scan_tab_contents |title=Q Fever on JSTOR |format= |work= |accessdate=}}</ref>
*It was previously classified as a ricketsia, but now is considered a proteobacterium.
*It was previously classified as a [[Rickettsiae|rickettsia]], but now is considered a [[Proteobacteria|proteobacterium]].
{| class="wikitable"
{| class="wikitable"
![[Image:Q_fever.jpg|center|300px|thumb|Coxiella brutenii ]]
![[Image:Q_fever.jpg|center|300px|thumb|Coxiella brutenii ]]
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[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]


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Revision as of 19:06, 12 June 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Q fever is a disease caused by C. brutenii, an intracellular gram-negative proteobacterium. The disease can have a wide range of clinical presentations and affect many organ systems due to the unique virulence factors of the organism.

Pathophysiology

Transmission:

The organism is transmitted through:[1]

  • Aerosoloes: Inhalation of contaminated aerosoles is the main mode of transmission.
  • Ingestion of raw dairy products
  • Vertical (mother to fetus) transmission has been reported
  • Parentral
  • Through tick bites

Pathogenesis:

C. Brutenii has the ability to exist in 2 forms:

Small cell form:[2]

Often described as the spore form of C. Brutenii Resists the external environmental factors as heat, pressure and disinfectants for long periods

Large cell form:

The active form of the organism Large cell form persists in the macrophages inside acidic vacuoles.

The infection has 2 phases that correlate with changes in the lipopolysaccharide of C. Brutenii:[3]

    • Phase I: characterized by smooth lipopolysaccharide capsule. Despite being less efficient in the invasion of host cells, antibodies against phase I is always isolated from acute Q fever patients.
    • Phase II: characterized by rough lipopolysaccharide capsule and antibodies against phase II have been isolated from chronic Q fever patients.

Q fever as a biological weapon:

  • Because of its route of infection it can be used as a biological warfare agent.
  • Q-fever is category "B" agent. It is highly contagious and very stable in aerosols in a wide range of temperatures.
  • Just 1-2 particles are enough to infect an individual.
  • Q-fever microorganisms may survive on surfaces up to 60 days (like sporulating bacteria).
  • According to WHO estimates[4], an amount of 50 kg of C. Brutenii if spread in an area of 2 square kilometers is capable of:
  • Infecting 500,000 humans
  • Killing 150 individuals
  • Causing acute illness in 125,000 individuals
  • Causing chronic illness in 9,000 individuals

Microscopic pathology:

Coxiella brutenii
Immunohistochemical detection of Coxiella burnetii in resected cardiac valve of a 60-year-old man with Q fever - By Mahamat A, Edouard S, Demar M, Abboud P, Patrice J-Y, La Scola B, et al. -Public domain-, via Wikime

References

  1. Marrie TJ (1990). "Q fever - a review". Can. Vet. J. 31 (8): 555–63. PMC 1480833. PMID 17423643.
  2. "Diagnosis of Q Fever".
  3. Choyce DP (1992). "Anterior chamber lens exchange". J Cataract Refract Surg. 18 (5): 537. PMID 1489455.
  4. "apps.who.int" (PDF).
  5. "Q Fever on JSTOR".

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