From the Guidelines
Cattleman's disease, also known as Q fever, should be treated with doxycycline 100mg twice daily for 2-3 weeks in acute cases, and a combination of doxycycline 100mg twice daily plus hydroxychloroquine 200mg three times daily for at least 18-24 months in chronic cases, such as endocarditis, to prevent complications and reduce mortality.
Diagnosis and Treatment
The diagnosis of Q fever is based on clinical presentation, laboratory tests, and epidemiologic history 1. Acute Q fever symptoms vary, but the condition is typically characterized by a nonspecific febrile illness, hepatitis, or pneumonia. Chronic Q fever can manifest within a few months or several years after acute infection and can follow symptomatic or asymptomatic infections.
- Key points for diagnosis and treatment include:
- Recognizing common epidemiologic features and clinical manifestations of Q fever
- Considering Q fever as the cause of a patient’s illness if appropriate
- Obtaining relevant history and diagnostic tests for Q fever
- Making treatment decisions based on epidemiologic and clinical evidence
- Recognizing doxycycline as the treatment of choice for patients of any age with severe illness 1
Prevention and Control
Prevention measures are crucial to reduce the risk of Q fever transmission.
- Key prevention measures include:
- Wearing protective clothing when handling livestock
- Proper disposal of animal birth products
- Pasteurization of milk
- Avoiding consumption of unpasteurized dairy products
- Reducing exposure to contaminated dust particles 1
Occupational Exposures
Q fever is an occupational disease in persons whose work involves contact with animals, such as slaughterhouse workers, veterinarians, and farmers. However, infection is not limited to these groups, and urban outbreaks and cases with no known exposure or close proximity to livestock have been reported 1.
- Key points for occupational exposures include:
- Recognizing Q fever as an occupational disease
- Providing effective risk communication for persons at high risk for Q fever exposure
- Reporting suspect and confirmed cases to appropriate public health officials 1
From the FDA Drug Label
Cattleman’s disease is not mentioned in the provided drug label. The FDA drug label does not answer the question.
From the Research
Cattleman's Disease Overview
- Cattleman's disease is also known as Q fever, a zoonotic disease caused by the bacterium Coxiella burnetii 2, 3.
- The disease can manifest as an acute or chronic infection, with acute symptoms including fever, headache, and myalgia, while chronic symptoms often present as endocarditis 2, 3.
Transmission and Reservoirs
- The main reservoirs of infection are farm animals and pets, with transmission to humans occurring primarily through inhalation of contaminated aerosols 3, 4.
- Dairy cattle are a significant reservoir of the disease 4.
Diagnosis and Treatment
- Diagnosis is based on serology and nucleic acid amplification (PCR) 4.
- Treatment for acute Q fever typically involves a 2-week course of doxycycline, while chronic disease requires 18-24 months of doxycycline in combination with hydroxychloroquine 2, 5.
- Alternative treatments, such as co-trimoxazole, may be used for pregnant women, young children, and those who cannot tolerate doxycycline 2, 4.
Treatment Efficacy and Duration
- The combination of doxycycline and hydroxychloroquine has been shown to reduce the treatment duration for chronic Q fever from 60 to 26 months 5, 6.
- However, there is still a lack of substantial evidence supporting the effectiveness of this treatment, and further research is needed to establish consensus among the medical community 6.