Truckin' pneumonia—an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens

Abstract

SUMMARYWe describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats, the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to kittens 2 weeks prior to the first case of Q fever in the plant. The cat owner fed the kittens every day before coming to work as the cat would not let the kittens suckle. Serum from the cat had high antibody titres to phase I and phase II Coxiella burnetii antigens. The attack rate among the employees where the cat owner worked, 13 of 19 (68 %), was higher than that of employees elsewhere, 3 of 13 (28%) [l' < 001]. The cat owner's wife and son also developed Q fever. None of the family members of the other employees with Q fever was so affected.We conclude that this outbreak of Q fever probably resulted from exposure to the contaminated clothing of the cat owner.

Coxiella burnetii Infection in a Community Operating a Large-Scale Cow and Goat Dairy, Missouri, 2013

“…C. burnetii transmission via aerosols generated from contaminated clothing and other fomites has been described. 26,27 In Community A, bringing work boots worn on the farm inside of one's residence was associated with increased risk of being a case among workers and their household members. Boot or shoe contamination and related foot traffic could result in C. burnetii introduction into areas beyond the farm as has been proposed as a source of C. burnetii contamination within homes in other Q fever outbreaks.…”

Q Fever Update, Maritime Canada

“…A typical scenario was exposure to the parturient family cat and her newborn kittens, after which everyone in the family became ill (2). Some outbreaks involved poker players (5) or most of the employees of a factory (6). For our study, we carefully asked whether family members were ill; only 2 patients mentioned such illness, and for each, it was a spouse.…”

Q fever

“…As many as 50% of exposed persons may develop an antibody response without having signs of clinical illness. The acute disease is generally nonspecific and may include fever (75 to 91%), headache (53 to 67%), myalgias (38 to 73%), and cough (approximately 38%) [22][23][24][25] ; other common symptoms may include fatigue, rigors, night sweats, and nausea or vomiting. In France, 34% of patients with acute Q fever have clinical signs of pulmonary disease, and 27% have abnormal findings on thoracic radiography.…”