Chile’s Undersecretary of Health confirmed that 43 people, the majority of whom are dairy industry workers, in southern Chile have been diagnosed with Q fever, a rare but highly infectious and potentially deadly disease; 20 of them have been hospitalized. Although it is a disease that can be found worldwide, this is the largest known Q fever outbreak in Chile, and health authorities there have asked for international support.
What is Breaking Out
Q fever is a rare disease caused by a bacteria found naturally in animals. Cattle, sheep, and goats are the primary carriers, although a variety of species (including domesticated mammals) may be infected. Humans generally are infected by breathing in dust that has been contaminated by infected animal feces, urine, milk, and/or birth byproducts.
There is some concern about Q fever being transmitted in unpasteurized milk products, but the bacteria do not survive the milk pasteurization process.
Q fever is highly infectious; however, more than half of acute infections are mild or asymptomatic. Symptoms may include fever, chills/sweats, head or muscle aches, nausea or vomiting, chest or stomach pains, weight loss, or non-productive cough. Pneumonia or hepatitis can be present in acute infections. The symptoms vary from patient to patient and can be difficult to distinguish from other diseases. A very small percentage (less than 5%) of people who become infected with Q fever develop a more serious infection called chronic Q fever, which is serious and can be fatal if not treated correctly.
The incubation period is generally 2-3 weeks but may be shorter after exposure to large numbers of organisms.
Where is it Occurring?
While the bacteria exists worldwide (with the exception of New Zealand), Q fever outbreaks are common in Africa and the Middle East. Q fever was first recognized as a human disease in Australia in 1935; Chile has asked Australian health authorities to help investigate its own outbreak. The largest known Q fever outbreak occurred in 2007-2010 in the Netherlands and involved nearly 4,000 cases.
There was also an outbreak of Q fever in Germany in 2015 involving medical tourists from the U.S. and Canada. These tourists received “live cell therapy” involving injections of fetal sheep cells—a procedure sometimes called anti-aging therapy. (See OSAC’s Report: “Medical Tourism Surging”)
This particular outbreak is occurring in the Los Rios and Los Lagos regions of southern Chile, more than 1,100 km south of the capital, Santiago (see attached map).
When Does it Occur?
Although cases of Q fever can occur during any month, most cases report illness beginning in the spring and early summer months (spring begins September 22 and summer begins December 21 in the southern hemisphere). These increases coincide with increases in outdoor activity and with the birthing season for a number of domesticated animal species.
The organism responsible for Q fever is extremely hardy and resistant to heat, drying, and many common disinfectants, which enable the bacteria to survive for long periods in the environment. The bacteria may also be carried long distances by wind.
Who is Impacted?
Travelers who visit rural areas or farms with cattle, sheep, goats, or other livestock may be exposed to Q fever. Occupational exposure to infected animals, particularly during birthing, poses a high risk for disease transmission. Q fever could also affect veterinarians, meatpacking and abattoir workers, farmers, and animal researchers, as well as anyone visiting an affected farm. Transmission is also possible to people who are in indirect contact with infected animals or items infected animals may have contacted.
Victims are often more likely to be male, as jobs at high risk for Q fever exposure may be more commonly held by men. More cases of Q fever are also reported in persons of older age.
Why Should I be Concerned?
Livestock production (including pasturing, abattoir, and dairy) is significant in southern Chile; pastures constitute a major land use, and the livestock sector is the second-largest contributor to agricultural GDP. An outbreak that impacts livestock and humans could impact the country’s economy and burgeoning agro-tourism sector.
Australia does have a vaccine available for Q fever, but it has multiple side effects and is expensive. There is no vaccine available in the U.S. for Q fever, but it can be treated with antibiotics, which are most effective at preventing severe complications if started within the first three days of symptoms. Even without treatment, though, most people recover.
The U.S. Centers for Disease Control & Prevention (CDC) considers Q fever a category B (the second-highest priority) bioterrorism agent. The U.S. Defense Threat Reduction Agency (DTRA), which continues to lead efforts for an effective vaccine, contends that rogue nations or groups could develop Q fever into a biological weapon to weaken (not kill) U.S. military forces.
How do I Respond?
The CDC recommends the following prevention guidelines:
Reduce your risk of getting Q fever by avoiding contact with animals, especially while they are giving birth.
Do not consume non-pasteurized milk and milk products.
People working in high-risk industries may need to take extra precautions.
If travelers have been to an area with known Q fever transmission, or have possible occupational exposure and report flulike illness up to 40 days after travel, include a travel history in discussions with a physician.
For More Information
For additional information on global diseases and pandemic outbreaks, please contact OSAC’s Global Health and Outbreaks Analyst. For information on the security climate in Chile, please contact OSAC’s Western Hemisphere Team.
Other OSAC Sources
2017 Chile Crime and Safety Report
Q fever page
Outbreak News Today