Francoise,

Q fever is considered a zoonotic disease (spread to humans by infected
animals).  Has Mother-To-Child-Transmission(MTCT) of Coxiella burnetti (the
bacterium responsible for Q fever) been proven? According to a New South
Wales (Australia) Public Health Sheet, "the disease is transfered to humans
when they inhale droplets contaminated with the bacteria and produced during
the slaughter of an infected animal or through the waste products (urine,
faeces, milk, and birth by products of an infected animals)."  This seems to
be an occupational hazard of people who work with livestock.  The factsheet
goes on to say that there are antibiotics that are effective against Coxiella
burnetti.
http://www.health.nsw.gov.au/public-health/phb/HTML2002/aug02html/factsheetqfe

ver.html

Secretory IgA is known to be active against Coxiella burnetti in vitro and
the component Heparin in human milk is active against chlamydia in vitro.  So
I guess I have a number of questions regarding the decision to advise against
breastfeeding.
If the mother is treated with antibiotics while pregnant (and they say
antibiotics are effective), wouldn't the baby also be treated?  How would
this disease be a threat by breastfeeding, if the mother is treated?  (This
factsheet states that "usually people with an acute infection make a full
recovery and rarely have a second attack of the disease.")

I think some assumptions have been made without evidence.  While Q fever is
spread by the milk of livestock animals, what proof is that human milk
transfers this bacteria to the infant?  And even if human milk transfers this
bacteria, does it cause infection? It would seem highly likely that human
milk offers protective elements similar to vaccination against this disease.
(rather important since this mother is a farmer and her children will be
growing up in an environment where exposure to this disease will be very
likely) More importantly, what are the health consequences of not being
breastfed?  We know they are significant even in developed countries.  Do the
consequences of not breastfeeding outweigh the theoretical risks of Q fever
for the infant? This mother needs a second or third medical opinion in regard
to this situation.
Valerie W. McClain, IBCLC

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