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Q fever: treatment and prevention
Last reviewed: 23.04.2024
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Treatment of fever includes etiotropic, pathogenetic and symptomatic therapy. Etiotropic treatment of fever is based on the use of antibiotics tetracycline group and levomycetins (standard treatment). Tetracycline in the first days of the disease (before the normalization of temperature) appoint 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. When tetracyclines are intolerant, rifampicin and macrolides (azithromycin) may be used. The duration of the course of antibiotic therapy for ku-fever is higher than for other rickettsiosis, and is 8-10 days. The introduction of smaller doses of antibiotics and the short course of etiotropic therapy does not prevent relapses, and also is ineffective in complications (endocarditis, hepatitis). With a severe form of ku-fever and lack of effect, parenteral use of antibiotics is considered optimal.
Long-term radiologic changes in the lungs are not considered an indication for the prolongation of etiotropic therapy. In chronic forms of fever with development of endocarditis, a cough-fever (at least 2 months) with tetracycline (0.25 mg four times daily) is administered in combination with co-trimoxazole (960 mg per day).
In severe long 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 terms of incapacity for work
Approximately 50% of people who have suffered the disease in various forms remain disabled for one month, and patients with severe form are unable to work for 2-3 months. After the establishment of normal temperature, which necessitates a medical examination to determine the ability to work, especially in cases where ku-fever is a professional disease.
This circumstance, as well as the possibility of recurrence, testify to the need for a long-term follow-up of doctors for all persons who have suffered a fever, until the disappearance of residual symptoms from all organs and systems. In accordance with the sanitary rules and norms of persons who have recovered with koksiellosis, they put on dispensary records for two years.
Dynamic control over the electrocardiogram and the state of the cardiovascular system is mandatory.
How is ku-fever prevented?
Patients with ku-fever or persons suspected of this disease are hospitalized in ward-boxes of the infectious disease department. The focus is on the current and final disinfection with chlorine-containing solutions. Individuals from the focus of infection are urgently treated with fever: doxycycline 0.2 g once daily or rifampicin 0.3 g twice daily for 10 days.
They carry out a complex of veterinary, anti-epidemic and sanitary-hygienic measures: anti-maltreatment of pastures, protection of livestock farms against introduction of pathogens, etc. Milk from dysfunctional farms can be consumed only in boiled form (pasteurization is not enough). To care for sick animals, individuals who have been ill with coxiellosis, vaccinated against this infection or who have a positive RBC at a dilution of 1:10 or more and / or a positive RNIF at a titer of 1:40 are allowed to take care of sick animals. Use protective clothing. In endemic foci, an active sanitary and educational work is carried out.
Vaccination against ku-fever is carried out for persons at risk (cattle breeders, meat-packing workers, veterinarians, zootechnicians, workers for processing livestock raw materials) with dry-cutaneous ku-fever vaccine M-44. It is administered by the method of scarification in a dose of 0.05 ml once. Revaccination - after one year. A general and local reaction to the administration of the vaccine is possible.