Open Veterinary Journal, (2025), Vol. 15(6): 2283-2283

Letter to the Editor

10.5455/OVJ.2025.v15.i6.1

Q-fever outbreak in Nepal: Urgent actions needed

Krishna Prasad Acharya^1* and Sarita Phuyal²

¹Animal Disease Investigation and Control Division (ADICD), Department of Livestock Services (DLS), Lalitpur, Nepal

²Department of Livestock Services (DLS), Central Referral Veterinary Hospital (CRVH), Kathmandu, Nepal

*Correspondence to: Krishna Prasad Acharya. Animal Disease Investigation and Control Division (ADICD), Department of Livestock Services (DLS), Lalitpur, Nepal. Email: kpa26 [at] cantab.ac.uk

Submitted: 19/04/2025 Revised: 02/05/2025 Accepted: 09/05/2025 Published: 30/06/2025

On February 20, 2024, the Central Veterinary Laboratory, a referral veterinary laboratory in Nepal, confirmed the first outbreak of Q-fever in the country. As of October 17, 2024, four outbreaks of Q-fever have been reported from three different districts, namely Kailali, Tanahu, and Chitwan. This highlights the need for immediate public health interventions to contain the disease and safeguard public health in Nepal.

Q-fever is a zoonotic disease caused by Coxiella burnetii, an obligate intracellular gamma-proteobacterium (Dragan and Voth, 2020). It is characterized by symptoms ranging from asymptomatic infections to fatal. It mainly involves reproductive disorders, such as late abortion, stillbirth, metritis, and infertility, in both humans and animals (Raoult et al., 2002; WOAH, 2018). Coxiella burnetii, a pathogen causing Q-fever, is distributed in the environment and can spread via the inhalation of aerosols contaminated with parturient fluids or placenta (Raoult et al., 2002). Outbreaks of Q-fever have raised serious public health concerns due to its zoonotic nature and the high risk of widespread transmission, given the poor sanitation and hygiene practices followed in Nepal. Thus, it is high time that the Government of Nepal responds swiftly to outbreaks by enhancing surveillance and contact tracing of confirmed cases and containing this disease.

There is an absence of surveillance systems and a national database system to record such cases of Q-fever in Nepal, which requires building the capacity for timely detection and response to Q-fever. A comprehensive surveillance and epidemiological investigation using a multisectoral one-health approach is needed to unravel the source of the disease, its burden, and transmission dynamics, which can help guide the prevention and control of Q-fever in Nepal. The prevention and control of Q-fever should involve a multisectoral one-health approach involving the following strategies: i) early detection through active surveillance and isolation of the cases; ii) contact tracing to trace the possibly infected individuals; iii) treatment of positive cases; and iv) implementation of sanitation and hygiene measures to halt the spread of pathogen, which can help prevent the spread of bacteria and future outbreaks. In particular, surveillance activities should target areas with a history of reproductive issues, such as stillbirths and abortions.

Conflict of interest

None to declare.

References

Dragan, A.L. and Voth, D.E. 2020. Coxiella burnetii: international pathogen of mystery. Microbes Infect. 22, 100–110; doi: 10.1016/j.micinf.2019.09.001

Raoult, D., Fenollar, F. and Stein, A. 2002. Q fever during pregnancy: diagnosis, treatment, and follow- up. Arch. Intern. Med. 162, 701–704; doi: 10.1001/archinte.162.6.701

WOAH, 2018. Q fever Chapter 3.1.16. Paris, France: WOAH, pp: 1–19.