Four Cases of Laboratory Acquired Q Fever: Lessons from the Past and a Brief Review of Literature

The aim of this communication is to highlight the dangers of Q fever outbreaks in laboratories attempting isolation of Coxiella burnetii (C. burnetii) and other rickettsiae without Bio Safety Level (BSL)-3 facilities. This series is reported for the benefit of Microbiologists who evince interest in Rickettsial research. Four cases of Laboratory-acquired Q fever is presented among the laboratory personnel in a tertiary care teaching Hospital in Karnataka in 1977, which has not been reported yet. Four persons (one Lecturer, one animal technician and two M.Sc. students) who assisted in blood collection from slaughtered domestic livestock from butcheries and/or participated in the isolation of C. burnetii by guinea pig inoculation became seropositive for Q fever. The presence of antibodies to C. burnetii was demonstrated by two specific serological tests, Micro Agglutination Test (MAT) and Complement Fixation Test (CFT) for Q fever. They responded well to treatment with oxytetracycline, the drug of choice. It should be known that even microscopic demonstration of C. burnetii and other rickettsiae in the ectoparasites is hazardous, due to liberation of infective aerosol in the process. A safe commercial Q fever vaccine for laboratory and farm workers is presently available in Australia alone. Therefore, preventive measures like use of BSL-3 facility in the laboratory as well as animal house, wearing N95 face masks and protective clothing (PPE) are some of the essential precautions to follow so as to prevent laboratory acquired Q fever infection, which is an important occupational hazard.