Q fever outbreak in a slaughterhouse in Brazil: description and decade-later investigation
6 affiliations
- 1Department of Preventive Veterinary Medicine and Animal Health, University of São Paulo, São Paulo, Brazil
- 2School of Public Health, University of São Paulo, São Paulo, Brazil
- 3Municipal Health Secretariat, Department of Health Surveillance, Barbosa, São Paulo Brazil
- 4Epidemiological Surveillance Center, Epidemiological Surveillance Group, São Paulo State Health Secretariat, Disease Control Coordination, São Paulo, Brazil
- 5Epidemiological Surveillance Service, University of Campinas, Hospital of Clinics, Campinas, Brazil
- 6Adolfo Lutz Institute, Vector-Borne Diseases Center, São Paulo, Brazil
Abstract
Purpose: To describe the first Q fever outbreak in Brazil and the long-term clinical and serological outcomes of affected individuals ten years after the outbreak.
Methods: A follow-up investigation was conducted among patients involved in a Q fever outbreak that occurred in 2015 in a slaughterhouse in Barbosa, São Paulo State, Brazil. Clinical records from the acute phase were reviewed, and patients were reevaluated ten years later through clinical assessment, review of medical history, serological testing, and molecular analysis.
Results: The outbreak affected 17 of 40 slaughterhouse workers (attack rate = 42.5%) and was likely associated with the inhalation of Coxiella burnetii during the slaughter of pregnant cows. Patients presented with prolonged fever, headache, myalgia, pneumonia, hepatitis, and hematuria; six required hospitalization. Ten years later, 14 patients were reevaluated. Of these, 10 developed complications compatible with chronic Q fever, including cardiac and respiratory disorders, as well as persistent fatigue. One woman experienced a premature birth after becoming pregnant following the outbreak. In 2025, one patient presented a phase I antibody endpoint titer of 1:1024 and a history of endocarditis, suggesting persistent infection.
Conclusion: This study provides a unique description of the long-term clinical and serological outcomes of workers involved in the first documented Q fever outbreak in Brazil and emphasizes the importance of post-outbreak surveillance and prolonged clinical follow-up.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02922-8.
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BibTeX
@article{franca2026fever,
title = {{Q fever outbreak in a slaughterhouse in Brazil: description and decade-later investigation}},
author = {Danilo A. França and Igor S. Silito and Matheus Pasini-Martins and Leila C. Saad and Tais B. Carvalho and Milenne U. S. Dias and Rodrigo N. Angerami and Fabiana C. P. Santos and Silvia Colombo and Marcelo B. Labruna},
journal = {Infection},
year = {2026},
month = aug,
doi = {10.1007/s15010-026-02922-8},
url = {https://doi.org/10.1007/s15010-026-02922-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Q fever outbreak in a slaughterhouse in Brazil: description and decade-later investigation
AU - Danilo A. França
AU - Igor S. Silito
AU - Matheus Pasini-Martins
AU - Leila C. Saad
AU - Tais B. Carvalho
AU - Milenne U. S. Dias
AU - Rodrigo N. Angerami
AU - Fabiana C. P. Santos
AU - Silvia Colombo
AU - Marcelo B. Labruna
PY - 2026
DA - 2026/08/24
JO - Infection
DO - 10.1007/s15010-026-02922-8
UR - https://doi.org/10.1007/s15010-026-02922-8
AB - Purpose: To describe the first Q fever outbreak in Brazil and the long-term clinical and serological outcomes of affected individuals ten years after the outbreak. Methods: A follow-up investigation was conducted among patients involved in a Q fever outbreak that occurred in 2015 in a slaughterhouse in Barbosa, São Paulo State, Brazil. Clinical records from the acute phase were reviewed, and patients were reevaluated ten years later through clinical assessment, review of medical history, serological testing, and molecular analysis. Results: The outbreak affected 17 of 40 slaughterhouse workers (attack rate = 42.5%) and was likely associated with the inhalation of Coxiella burnetii during the slaughter of pregnant cows. Patients presented with prolonged fever, headache, myalgia, pneumonia, hepatitis, and hematuria; six required hospitalization. Ten years later, 14 patients were reevaluated. Of these, 10 developed complications compatible with chronic Q fever, including cardiac and respiratory disorders, as well as persistent fatigue. One woman experienced a premature birth after becoming pregnant following the outbreak. In 2025, one patient presented a phase I antibody endpoint titer of 1:1024 and a history of endocarditis, suggesting persistent infection. Conclusion: This study provides a unique description of the long-term clinical and serological outcomes of workers involved in the first documented Q fever outbreak in Brazil and emphasizes the importance of post-outbreak surveillance and prolonged clinical follow-up. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02922-8.
SN - 0300-8126
SN - 1439-0973
ER -