1. Washington State Department of Agriculture Washington State University Grant County Health District

2. Q Fever Q fever is a rare bacterial infection in people around the world caused by Coxiella burnetii Q fever spills over to people, from infected animals/ environment, through inhalation The bacteria can cause a sudden onset of: high fever often with night sweats headache and flu-like symptoms that usually last for at least a week

3. Q fever in Washington, 2011 Discovered because Producer wanted to know the source of abortions in goat herd (April 2011) Q fever diagnosed because placenta was sent to WSU by local Veterinarian Producer assisted with tracing herd sales in WA and MT Grant County Health District sent an alert to medical providers

4. 2011 Washington State Study Goats were tested from 13 farms in 7 counties: Adams, Chelan, Clark, Franklin, Grant, Pend Oreille & Thurston The following samples were collected by WSDA, USDA and CDC veterinarians: 326 Blood samples 312 Vaginal swabs 108 Fecal swabs 37 Milk samples Environmental samples were taken from a few farms Humans: 61 samples were collected from Producers and Agriculture personnel

5. Lab testing for Q fever Serology – CF or ELISA Detects antibodies produced against bacteria LIVE bugs?- grow the bacteria (culture) at CDC PCR = polymerase chain reaction Detects and amplifies the bacteria (LIVE or DEAD)

6. Results From All Washington Farms PEOPLE: 11 / 61 (18%) had positive serum samples 7 / 11 (64%) people were sick 4 / 11 (36%) people were not sick GOATS: All whole blood samples were PCR negative Only 8% of 326 goats were ELISA positive Only 10% of 108 fecal swabs (males) were PCR positive 31% of 312 vaginal swabs were PCR positive All 19 positive milk samples were from one non-milk producing farm

7. Farm Links 3 positive does on one farm were not from Farm A One of those positives had never been off of the farm Does bred at Farm A were ELISA and PCR negative Q fever is ubiquitous, so positive animals should be found throughout the state WSU conducting study of goats around WA

8. Environmental Results Environmental testing was based on a quantitative PCR assay targeted to a specific gene (IS1111). PCR assay does not determine viability Positive scale in genomes / gram: Low: <= 10 (normal background) Moderate: >10 – 1,000 Strong: > 1,000 – 100,000 Extremely strong: >100,000 The farms with the highest level of shedding among their goats had the highest genomes/gram in the environment

9. Environmental Results CDC isolated live Coxiella burnetii from the WA goat placenta and a vaginal swab taken from a Montana goat. The 2 isolates and a WA environmental sample are in the same genetic group (sequence type 8). Sequence type 8 was previously seen in a chronic human Q fever case in Washington State with no connection to goats. Sequence type 8 has also been found in several other goats and chronic human cases in the US.

10. Presence of Coxiella burnetii DNA in the Environment of the United States, 2006 to 2008 http://aem.asm.org/content/76/13/4469.full.pdf+html http://aem.asm.org/content/76/13/4469.full.pdf+html CDC found Q fever bacteria in environmental samples from post offices, stores, schools, farms, dairies and fairgrounds Rocky Mountains- 45% South Central – 36% Upper Midwest – 25% Deep South – 16% West Coast – 14% East Coast – 6% Some areas had up to 50% positive samples

11. Best Practices to Control Q Fever National seroprevalence: 10% in cattle 15-20% in sheep 25-35% in goats No real good numbers.

12. When/where is the most risk ? 2 weeks prior to one month after birth Lactation Abortions Placentas Birth fluids Kidding/lambing/calving barns

13. When/where is the most risk? The highest risk is due to contact with birth products such as placentas, birth fluids, etc. Use disposable gloves Barn only clothes Mask to reduce airborne bacteria in dust Remove any dead fetuses and placentas as soon as you can in plastic bags and burn or bury at least 3 feet Compost and spread on fields Risk of selling manure Immediately clean birthing areas then apply 10% Bleach, 5% Hydrogen Peroxide, or 1% Lysol 30 minute contact time Keep down dust

14. Farm Biosecurity Limit access for visitors People with high risk to contract it are immune compromised, pregnant women, and heart valve patients. Wash hands and arms after animal contact Keep barn clothes out of the house Clean and disinfect boots

15. Farm Biosecurity Maintain good records of animal movements If your animal aborts, contact local veterinarian and save everything you can, especially placenta, for diagnostic evaluation Culling of animals based on blood tests is not recommended and won’t ensure a negative herd.

16. Resources Many links on our website www.agr.wa.govwww.agr.wa.gov Sublinks to CDC and university websites on: Composting Manure and animals Disinfection Basics of different products and what they will work on Boot cleaning Hand washing

17. Conclusion Q fever is everywhere. Individual animal serum test of little value. Q fever can not be traced to any one source with any reliability. All farms had multiple sources of animals or bred animals at multiple farms. The number of antibody positive animals in this investigation (8%) was lower than that of previous studies.

18. Acknowledgements Centers for Disease Control and Prevention Center for Food Security and Public Health at Iowa State University USDA- veterinarians and laboratorians WSU- Field Disease Investigative Unit and Lab All local county health jurisdictions