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Q fever - Treatment and prevention
Last reviewed: 08.07.2025
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Treatment of Q fever includes etiotropic, pathogenetic and symptomatic therapy. Etiotropic treatment of Q fever is based on the use of tetracycline antibiotics and chloramphenicol (standard treatment). Tetracycline is prescribed in the first days of the disease (until the temperature is normalized) at 0.4-0.5 g four times a day, then 0.3-0.4 g four times a day for another 5-7 days, doxycycline - 200 mg / day, chloramphenicol - 0.5 g four times a day. In case of intolerance to tetracyclines, rifampicin and macrolides (azithromycin) can be used. The duration of antibiotic therapy for Q fever is longer than for other rickettsioses and is 8-10 days. Administration of smaller doses of antibiotics and a short course of etiotropic therapy does not prevent relapses and is also ineffective in complications (endocarditis, hepatitis). In severe cases of Q fever and lack of effect, parenteral administration of antibiotics is considered optimal.
Long-term radiographic changes in the lungs are not considered an indication for prolongation of etiotropic therapy. In chronic forms of Q fever with the development of endocarditis, Q fever is treated (at least 2 months) with tetracycline (0.25 mg four times a day) in combination with co-trimoxazole (960 mg per day).
In severe cases of protracted and chronic forms, it is possible to use antibacterial drugs in combination with glucocorticoids (prednisolone 30-60 mg/day) for 5-8 days.
Convalescents are discharged from the hospital after complete clinical recovery.
[ Approximate periods of incapacity for work
Approximately 50% of people who have suffered from the disease in various forms remain incapacitated for one month, and patients with a severe form are incapacitated for 2-3 months after the normal temperature is established, which necessitates a medical examination to determine the ability to work, especially in cases where Q fever is an occupational disease.
This circumstance, as well as the possibility of relapse, indicate the need for long-term medical observation of all persons who have had Q fever, until the complete disappearance of residual symptoms from all organs and systems. In accordance with sanitary rules and regulations, persons who have had coxiellosis are registered for two years.
Dynamic monitoring of the electrocardiogram and the state of the cardiovascular system is mandatory.
How is Q fever prevented?
Patients with Q fever or persons suspected of having this disease are hospitalized in the wards of the infectious diseases department. The focus is subject to routine and final disinfection with chlorine-containing solutions. Persons from the focus of infection are given emergency treatment for Q fever: doxycycline 0.2 g once a day or rifampicin 0.3 g twice a day for 10 days.
A range of veterinary, anti-epidemic and sanitary-hygienic measures are carried out: anti-tick treatment of pastures, protection of livestock farms from the introduction of pathogens, etc. Milk from affected farms can only be consumed boiled (pasteurization is not enough). Persons who have had coxiellosis, have been vaccinated against this infection or have a positive RSK in a dilution of 1:10 or more and (or) a positive RNIF in a titer of 1:40 are allowed to care for sick animals. Protective clothing is used. Active sanitary and educational work is carried out in endemic foci.
Vaccination against Q fever is carried out for people from the risk group (livestock breeders, meat processing plant workers, veterinarians, zootechnicians, workers processing livestock raw materials) with the Q fever vaccine M-44 live dry cutaneous. It is administered by scarification in a dose of 0.05 ml once. Revaccination is after one year. General and local reactions to the introduction of the vaccine are possible.