How is Coxiella burnetii transmitted in animals?

• A. Direct contact with infected animals
• B. Direct contact with contaminated environment
• C. Inhalation of aerosolized bacteria
• D. All of the above

Answer: (D)

Coxiella burnetii is shed by infected animals in several ways and remains viable in the environment, so multiple transmission routes are possible. It is released in birth fluids, placental tissue, milk, urine, and feces, and these materials can become aerosolized or contaminate surfaces and bedding. Because people and other animals can become infected by inhaling these aerosols, by direct contact with infected animals, or by exposure to a contaminated environment, all of the listed routes are plausible. Therefore, the best answer is that all of the above describe transmission pathways in animals.