Comprehensive literature review of the sources of infection and transmission routes of Coxiella burnetii, with particular regard to the criteria of “evidence-based medicine”

Abstract The present review aims to compile the currently available literature since 1936 according the sources of infection of the Q fever pathogen ( Coxiella (C.) burnetii ) as well as the transmission from animal to man and also from human to human. In terms of quality and validity, the existing publications were reviewed systematically. For this purpose, firstly a structured literature search was carried out using various databases and search engines supplemented by a manual literature search. For critical appraisal, 1444 relevant publications were identified for the moment and evaluated. A total of 73 publications describing a transmission of C. burnetii from animals to man or a human-to-human transmission were discovered. The identified publications are 29 case series, two case reports, 21 cohort studies and 21 case-control studies. With regard to the sources of infection, 25 publications describing the transmission of C. burnetii from sheep to humans could be identified.