{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:53:10Z","timestamp":1784073190504,"version":"3.55.0"},"reference-count":37,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,2]]},"abstract":"<jats:p><jats:italic>Coxiella burnetii<\/jats:italic> is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated <jats:italic>C. burnetii<\/jats:italic> infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a <jats:italic>C. burnetii<\/jats:italic> phase II IgG titer \u2265 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3\u20135.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of <jats:italic>C. burnetii<\/jats:italic> on fomites within the community. A history of injection drug use was reported by 26\/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0726","type":"journal-article","created":{"date-parts":[[2016,1,26]],"date-time":"2016-01-26T03:58:34Z","timestamp":1453780714000},"page":"525-531","source":"Crossref","is-referenced-by-count":10,"title":["Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013"],"prefix":"10.4269","volume":"94","author":[{"given":"Holly M.","family":"Biggs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Turabelidze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne R.","family":"Todd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Jacobs-Slifka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi A.","family":"Drexler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"McCurdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Lloyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L.","family":"Evavold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A.","family":"Fitzpatrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael A.","family":"Priestley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Singleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert J.","family":"Kersh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"Diagnosis and management of Q fever\u2013United States, 2013: recommendations from CDC and the Q Fever Working Group","volume":"62","author":"Anderson","year":"2013"},{"key":"ref2","series-title":"Epidemiol Infect","first-page":"1332","article-title":"Antibiotic therapy for acute Q fever in the Netherlands in 2007 and 2008 and its relation to hospitalization","volume":"139","author":"Dijkstra","year":"2011"},{"key":"ref3","series-title":"Thorax","first-page":"276","article-title":"Antibiotic treatment in pneumonia due to Q fever","volume":"47","author":"Sobradillo","year":"1992"},{"key":"ref4","series-title":"Bacteriol Rev","first-page":"285","article-title":"Airborne Q fever","volume":"25","author":"Tigertt","year":"1961"},{"key":"ref5","series-title":"Appl Environ Microbiol","first-page":"1697","article-title":"Presence and persistence of Coxiella burnetii in the environments of goat farms associated with a Q fever outbreak","volume":"79","author":"Kersh","year":"2013"},{"key":"ref6","series-title":"Q Fever: The Biology of Coxiella burnetii","first-page":"223","article-title":"The development cycle of Coxiella burnetii","author":"McCaul","year":"1991"},{"key":"ref7","series-title":"Commun Dis Public Health","first-page":"180","article-title":"A large outbreak of Q fever in the West Midlands: windborne spread into a metropolitan area?","volume":"1","author":"Hawker","year":"1998"},{"key":"ref8","series-title":"Emerg Infect Dis","first-page":"1264","article-title":"Wind in November, Q fever in December","volume":"10","author":"Tissot-Dupont","year":"2004"},{"key":"ref9","series-title":"Am J Epidemiol","first-page":"67","article-title":"Hyperendemic focus of Q fever related to sheep and wind","volume":"150","author":"Tissot-Dupont","year":"1999"},{"key":"ref10","series-title":"Clin Infect Dis","first-page":"1591","article-title":"Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region","volume":"55","author":"Hackert","year":"2012"},{"key":"ref11","series-title":"Vector Borne Zoonotic Dis","first-page":"179","article-title":"Q fever in humans and animals in the United States","volume":"2","author":"McQuiston","year":"2002"},{"key":"ref12","series-title":"Exp Appl Acarol","first-page":"67","article-title":"Rickettsial agents in Egyptian ticks collected from domestic animals","volume":"40","author":"Loftis","year":"2006"},{"key":"ref13","series-title":"Appl Environ Microbiol","first-page":"4571","article-title":"Practical method for extraction of PCR-quality DNA from environmental soil samples","volume":"76","author":"Fitzpatrick","year":"2010"},{"key":"ref14","series-title":"Am J Trop Med Hyg","first-page":"691","article-title":"Seroprevalence of Q fever in the United States, 2003\u20132004","volume":"81","author":"Anderson","year":"2009"},{"key":"ref15","series-title":"Epidemiol Infect","first-page":"42","article-title":"Assessing Q fever in a representative sample from the United States population: identification of a potential occupational hazard","volume":"140","author":"Walsh","year":"2012"},{"key":"ref16","series-title":"PLoS One","first-page":"e96607","article-title":"Land-applied goat manure as a source of human Q-fever in the Netherlands, 2006\u20132010","volume":"9","author":"Hermans","year":"2014"},{"key":"ref17","series-title":"Prevention and Control of Coxiella burnetii Infection among Humans and Animals: Guidance for a Coordinated Public Health and Animal Health Response","author":"National Association of State Public Health Veterinarians, National Assembly of State Animal Health Officials","year":"2013"},{"key":"ref18","series-title":"Chemical and Microbiological Consequences of Anaerobic Digestion of Livestock Manure, A Literature Review. Interstate Commission on the Potomac River Basin, Report #96-6","author":"Casman","year":"1996"},{"key":"ref19","series-title":"Am J Trop Med Hyg","first-page":"247","article-title":"Q fever in the United States: summary of case reports from two national surveillance systems, 2000\u20132012","volume":"92","author":"Dahlgren","year":"2015"},{"key":"ref20","series-title":"Epidemiol Infect","first-page":"1084","article-title":"Large Q fever outbreak due to sheep farming near residential areas, Germany, 2005","volume":"136","author":"Gilsdorf","year":"2008"},{"key":"ref21","series-title":"United States Drought Monitor, Tabular Data Archive","author":"The National Drought Mitigation Center"},{"key":"ref22","series-title":"Epidemiol Infect","first-page":"1283","article-title":"Investigation of a Q fever outbreak in a rural area of the Netherlands","volume":"137","author":"Karagiannis","year":"2009"},{"key":"ref23","series-title":"Int J Environ Health Res","first-page":"441","article-title":"Q fever in the Netherlands: the role of local environmental conditions","volume":"21","author":"van der Hoek","year":"2011"},{"key":"ref24","series-title":"BMC Infect Dis","first-page":"69","article-title":"The use of a geographic information system to identify a dairy goat farm as the most likely source of an urban Q-fever outbreak","volume":"10","author":"Schimmer","year":"2010"},{"key":"ref25","series-title":"Lancet","first-page":"1002","article-title":"Q fever in an urban area","volume":"1","author":"Salmon","year":"1982"},{"key":"ref26","series-title":"Am J Hyg","first-page":"76","article-title":"Q fever in laundry workers, presumably transmitted from contaminated clothing","volume":"49","author":"Oliphant","year":"1949"},{"key":"ref27","series-title":"Epidemiol Infect","first-page":"119","article-title":"Truckin' pneumonia: an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens","volume":"102","author":"Marrie","year":"1989"},{"key":"ref28","series-title":"Clin Infect Dis","first-page":"312","article-title":"Risks factors and prevention of Q fever endocarditis","volume":"33","author":"Fenollar","year":"2001"},{"key":"ref29","series-title":"Medicine (Baltimore)","first-page":"109","article-title":"Q fever 1985\u20131998. Clinical and epidemiologic features of 1,383 infections","volume":"79","author":"Raoult","year":"2000"},{"key":"ref30","series-title":"Clin Infect Dis","first-page":"374","article-title":"Right-side endocarditis in injection drug users: review of proposed mechanisms of pathogenesis","volume":"30","author":"Frontera","year":"2000"},{"key":"ref31","series-title":"Acad Emerg Med","first-page":"911","article-title":"Prevalence of cardiac valve abnormalities in afebrile injection drug users","volume":"6","author":"Levitt","year":"1999"},{"key":"ref32","series-title":"Am J Cardiol","first-page":"238","article-title":"Findings on Doppler echocardiography in asymptomatic intravenous heroin users","volume":"69","author":"Pons-Llad\u00f3","year":"1992"},{"key":"ref33","series-title":"Am J Cardiol","first-page":"100","article-title":"Echocardiographic findings suggestive of infective endocarditis in asymptomatic Danish injection drug users attending urban injection facilities","volume":"114","author":"Axelsson","year":"2014"},{"key":"ref34","series-title":"Clin Microbiol Infect","first-page":"566","article-title":"Repeat endocarditis: analysis of risk factors based on the International Collaboration on Endocarditis: prospective cohort study","volume":"20","author":"Alagna","year":"2013"},{"key":"ref35","series-title":"Heart","first-page":"577","article-title":"Injection drug use and right sided endocarditis","volume":"89","author":"Moss","year":"2003"},{"key":"ref36","series-title":"Arch Intern Med","first-page":"1641","article-title":"Clinical features, site of involvement, bacteriologic findings, and outcome of infective endocarditis in intravenous drug users","volume":"155","author":"Mathew","year":"1995"},{"key":"ref37","series-title":"Vector Borne Zoonotic Dis","first-page":"111","article-title":"First reported multistate human Q fever outbreak in the United States, 2011","volume":"14","author":"Bjork","year":"2014"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/94\/3\/article-p525.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/94\/3\/article-p525.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/94\/3\/article-p525.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:11:53Z","timestamp":1723068713000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/94\/3\/article-p525.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,2]]},"references-count":37,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.15-0726","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,2]]}}}