Foot-and-mouth soldiers have Q fever

by Allan Ramsay

Three soldiers are recovering after being infected with the rare disease, Q fever, which they contracted while burying animals with foot-and-mouth, making them the first human victims of the epidemic, it was revealed today.

The servicemen began displaying symptoms of flu or pneumonia, with which Q fever is often confused, after they helped dispose of animal carcasses on a farm in Northumberland.

Two of the soldiers were treated in hospital after complaining of the symptoms, including breathing problems, but later released. It is not clear whether the third man needed hospital treatment.

Six other men, also believed to be soldiers, were screened for the fever but the results proved negatives.

Doctors and public health officials across Britain have been alerted to watch out for patients who may have worked on farms during the slaughter programme complaining of similar illness.

News of the first people to suffer health problems as a result of the foot-and-mouth epidemic was revealed not by the Department of Health but on the website of the Public Health Laboratory Service, the Government's monitor of infectious diseases.

A Ministry of Defence spokesman said: "This is like flu. You take antibiotics and get better. Clearly we have a duty of care to our people. The divisional operation order did warn of the hazards."

A Health Department spokesman said the general public was unlikely to be at increased risk from Q fever although a risk assessment released earlier during the epidemic suggested bacteria might be released for months from animal burial sites.

"It is known that the people who have had it so far have not had it through food," said the spokesman. "They were involved directly in disposal. It is a known risk. The disease itself is not a high-risk disease. The exposure among people who work on farms is very high because the bacteria are so common and widespread."

People handling animals, whether infected by foot-and-mouth or not, are at particular risk of catching the disease, especially from pregnant sheep and cattle, many of which have been killed during the recent cull.

Q fever is rare with only a few hundred cases reported each year, mainly in Ulster, although it is believed that numbers are under-reported because of its similarity to flu. One survey suggested that one in four farmers had the disease.

Thousands of soldiers, slaughtermen and troops were involved in the cull.There have been 1,788 confirmed outbreaks of foot and mouth and animals on more than 7,000 farms have been killed as a precaution.

So far 2.76million sheep, 537,000 cattle and 128,000 pigs have been killed.

© Associated Newspapers Ltd., 28 June 2001

-- PHO (owennos@bigfoot.com), June 28, 2001

Answers

<< It is a known risk. The disease itself is not a high-risk disease. The exposure among people who work on farms is very high because the bacteria are so common and widespread... >>

These are the key points.

Q fever often resolves without treatment and without long-term consequence. It can be fatal in some cases, however, if severe manifestations are untreated with appropriate antibiotics. This bacterial infection is an old, well-known risk to farmers and vets from infected animals, especially goats and sheep during birthing (placenta and various fluids are highly infectious, especially via aerosols, and the bacteria can survive several weeks in the environment).

<< One survey suggested that one in four farmers had the disease >>

Indeed, serologic ( = blood antibody) surveys of sheep and goat farmers in particular demonstrate that prior infection is common, and mostly the persons previously infected as shown by the antibodies deny previous severe illness.

<< making them the first human victims of the epidemic >>

Sort of a sensationalistic claim, although I suppose it's technically true.

-- Andre Weltman (aweltman@state.pa.us), July 02, 2001.

Here's the moderator's comment on this story, from PROMED, 2 July 2001 #153 (URL: www.promedmail.org):

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[This report is unclear about the nature of the causative organism, which is a rickettsia. Q fever, or rickettsial pneumonia, occurs world-wide.

Pneumonia is a frequent consequence of infection with an acute onset and in extreme cases possible involvement of heart valves and other organs. The Q fever rickettsia, _Coxiella burnetii_, is usually transmitted by inhalation of small particle aerosols that originate from infected animals. Q fever is enzootic among domestic animals, particularly cattle, sheep and goats. Q fever rickettsiae proliferate profusely in the placenta of infected females and are released abundantly at parturition. They are resistant in the environment and can be disseminated by dust, dried feces, nd other animal detritus.

Disease occurs sporadically in farm workers, but outbreaks are more frequent among abattoir workers. Q fever can also be contracted by consumption of contaminated raw milk. Ticks are a potential but rare source of human infection.

The present outbreak appears to be confined to military personnel employed in the slaughter and disposal of FMD-infected animals. Soldiers, in contrast to farm workers and slaughtermen, would be unlikely to have any prior immunity as a consequence of their normal employment. Furthermore they may have been assigned by default to the most emotionally disturbing tasks, such as the slaughter and disposal of pregnant sheep and recently born lambs.

- Moderator CP]

-- Andre Weltman, M.D. (aweltman@state.pa.us), July 03, 2001.