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Coxiella burnetii<\/em> bacteria in cultured cells. Source: NIH<\/p><\/div>\n The main natural carriers of the bacteria are sheep, goats, and cattle, but they are also found in other mammals, such as pets (dogs and cats) and various rodents. Carriers typically show no signs of illness, and the disease manifests chiefly during pregnancy. At that time the bacteria multiply in the female reproductive organs, uterus, and placenta, and even invade fetal cells. This leads to miscarriages or to the birth of infected and sick offspring, some of whom do not survive.<\/p>\n During parturition the bacteria are shed to the environment in every possible way: in feces, urine, milk, and uterine secretions. They also disperse as infectious aerosols, thereby entering the respiratory tracts of anyone nearby. When the bacteria reach humans, the illness begins with symptoms common to many diseases: headaches, fever, chills, and coughing. Pneumonia, hepatitis, endocarditis, and inflammation of other organs can follow, sometimes with fatal outcomes. Pregnant women may miscarry. In most cases, antibiotic treatment halts the disease\u2019s progression and aids recovery.<\/p>\n The epidemiological investigation, led by Joan Langley of Dalhousie University, ruled out links between the patients and rural areas, exposure to farm animals or wildlife, or consumption of unpasteurized dairy products. It was later discovered that all twelve patients were connected through the poker meetings, and specifically the session during which the cat gave birth. Examination of the cat revealed that her uterus was infected with the bacterium, and the two surviving kittens had been exposed as well. The link to the birth was conclusively confirmed when it was found that the host\u2019s children, who spent time with the cat but were not present during the delivery, had not been exposed. Everyone in the room at the time of the birth, when a bacterial aerosol was spead from the uterus into the poorly ventilated space or in the few hours afterward, inhaled the bacteria and became ill.<\/p>\n The remaining question is how the cat became infected, given that this was not a rural area. The investigators hypothesized that the cat had preyed on an infected mouse. If correct, the disease may not be confined to rural regions.<\/p>\n The event was described in the paper\u2019s title and in accompanying reports as \u201cPoker Players\u2019 Pneumonia.\u201d<\/p>\n Hebrew editing: Smadar Raban
\nEnglish editing: Elee Shimshoni<\/p>\n
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