... Accession Number : AD0680376. Title : Q FEVER IN THE URALS,. ... Abstract : Q fever was first identified in the Urals in June 1954. ...
DTIC Science & Technology
... Title : LABORATORY INFECTIONS WITH Q FEVER. ... In four other cases there was merely a suspicion that it was also a question of Q fever. ...
... Title : NEUTROPHILE ALKALINE PHOSPHATASE CHANGES IN TULAREMIA, SANDFLY FEVER, Q FEVER AND NONINFECTIOUS FEVERS. ...
... According to Reldolesi these Atypical Q fever forms can be ... Page 6. Acute Broncho-pneumonia form-q Fever accompanying bronchitis and/or ...
... 4. TITLE AND SUBTITLE Q Fever in US Military Returning from Iraq 5a. ... Q Fever in US Military Returning from Iraq To the Editor: ...
... Title : Q Fever in US Military Returning from Iraq. Descriptive ... Although unusual in the US, Q fever is endemic in the Middle East. Our ...
Responses of neutrophile AP were studied in volunteers during induced tularemia, Q fever, sandfly fever, and during artificial hyperthermia and endotoxin fever. Symptoms of typical early tularemia were accompanied by a slight increase in the neutrophile c...
National Technical Information Service (NTIS)
... study is a summary of the results of more than four years of research activities concerning the problem of morphology and pathogenesis of Q fever. ...
... disease. The main reservoir of Q-fever are the domestic animals, among which cattle have the most importance. Together ...
... Title : Q-FEVER (CLINICS, DIAGNOSIS AND TREATMENT). Corporate Author : ARMY BIOLOGICAL LABS FREDERICK MD. ...
... Accession Number : AD0678309. Title : Q FEVER. Corporate Author : ARMY BIOLOGICAL LABS FREDERICK MD. Personal ...
... Title : Identification, Cloning, and Expression of Potential Diagnostic Markers for Q Fever. ... Abstract : The clinical diagnosis of Q fever is difficult. ...
... Accession Number : AD0291040. Title : INTRADERMAL ALLERGY TEST FOR Q FEVER. Corporate Author : ARMY BIOLOGICAL ...
... Title : EXPERIMENT ON MASS VACCINATION AGAINST Q FEVER. REPORT 2. REMOTE RESULTS OF THE VACCINATION. ...
... Accession Number : AD0293213. Title : BIBLIOGRAPHY ON Q FEVER. Corporate Author : ARMY BIOLOGICAL LABS FREDERICK MD. ...
... Descriptors : *SWINE, *COXIELLA BURNETII, *Q FEVER, USSR, MUTATIONS, IONIZATION, TRANSLATIONS, CHICKENS, RICKETTSIA, SEX ...
... No evidence of incident cases of sandfly fever, Congo Crimean hemorrhagic fever, Rift Valley fever, Sindbis, Hantaan, dengue fever, typhus, or Q ...
... Accession Number : AD0291037. Title : INTRACUTANEOUS REACTION IN THE DIAGNOSIS OF Q FEVER IN GUINEA PIGS. ...
... Title : TEST ON MASS VACCINATION AGAINST Q-FEVER. REPORT I. REACTIVITY AND IMMUNOGENICITY OF THE Q-VACCINE. ...
... Dry cough (nonproductive) Fever Headache Joint pain ( arthralgia ) Muscle pains Other symptoms that may develop include: Abdominal pain ...
MedlinePLUS
A total of 485 Egyptian domestic animal sera, including samples from buffalos, camels, cows, donkeys, goats, pigs, and sheep, were screened for antibodies to Q fever rickettsiae. Twenty-six percent of these livestock sera agglutinated Q fever antigen at d...
We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection. PMID:20202433
PubMed
Q fever is a zoonotic infection caused by Coxiella burnetii that may present with acute or chronic clinical manifestations, including a nonspecific febrile illness, pneumonia, hepatitis, or endocarditis. Although unusual in the US, Q fever is endemic in t...
... Filoviridae (Ebola and Marburg) and Flaviviridae (yellow fever, dengue, Omsk haemorrhagic fever, Kyasanur forest disease). General information Q&As What is dengue and how is it treated? Fact sheets Dengue ...
... fever. Leport I- Reactivity and Imnunotenicity of the Q-va.Qcine. iZ. ... and computation of reactivity of the vcccine were noted. ...
... Accession Number : ADA049163. Title : Studies on Ecology of Q Fever in Native Fauna in the Great Salt Lake Desert. Descriptive ...
... Accession Number : ADA044263. Title : Metabolic Sequelae of Respiratory Q Fever in the Guinea Pig. Descriptive Note : Interim rept.,. ...
... Title : IMMUNIZATION OF MAN WITH THE LIVE M-44 Q-FEVER VACCINE. Corporate Author : ARMY BIOLOGICAL LABS FREDERICK MD. ...
... Title : Burnet's Rickettsia Disease (Q Fever). ... infiltrates of rickettsia Burneti proves that ... Descriptors : *COXIELLA, DISEASES, DIAGNOSIS(MEDICINE ...
... Accession Number : ADA187295. Title : Animal Models in Q Fever: Pathological Responses of Inbred Mice to Phase 1 Coxiella burnetti,. ...
... A .Change of the Properties of the Q-fever Causative Agent, Communi- cation I. Biological Properties of Variants D and BDl of the Grit Strain of ...
... As for all rickettsial diseases the problca of the wxdstance of the vector of this disease of Q fev..r presents itself as to the e ...
... Title : TO THE QUESTION OF THE DEGREE OF DISSEMINATION OF THE Q-FEVER AMONG THE WORKERS OF THE COTTON INDUSTRY. ...
... Title : THE EPIDEMIOLOGICAL IMPORTANCE OF ECTOPARASITES OF BIRDS IN A NATURAL FOCUS OF Q FEVER IN SOUTHERN CENTRAL ...
Since 2007, the Netherlands is faced with the largest outbreak of Q fever ever reported. In the last four years, over 4000 cases have been reported. The course of the epidemic and possible factors associated with this sudden surge in cases of Q fever is described and the preventive measures in the veterinary sector ...
... products. There is also noted a great intensivenes8 of the diseases in connection with dry and wars weather (wuoh dust). ...
... DISEASE VECTORS), (*DISEASE VECTORS, *MITES), RICKETTSIA, GUINEA PIGS ... PARASITES, USSR, INFECTIOUS DISEASES. ...
Following Coxiella burnetii infection, there is a 1 to 5% risk of chronic Q fever. Endocarditis, mycotic aneurysm, and vascular prosthesis infection are common manifestations. We present three patients with endocarditis by C. burnetii concomitant with another bacterial pathogen. Chronic Q fever should therefore be ...
... temperature. In the clinical chart the affection seems to be of the organs of respiration, indicated by the bronchitis and pneumonia. ...
Contents: Rift Valley Fever (RVF) Vaccine Development; Rift Valley Fever (RVF) HA Antigen; Rift Valley Fever (RVF) SA-51 Virus Strain; Vee Vaccine Development; WEE Vaccine Development, Chikungunya Vaccine Development; Q Fever Program; Rocky Mountain Spott...
...provides epidemiological information on these diseases. Rickettsia are generally transmitted by arthropods (e.g., ticks and mosquitoes) and produce infections in humans characterized by rash and fever (e.g., typhus fever, spotted fever, Q fever,...
Code of Federal Regulations, 2011
The 2007-2009 human Q fever epidemic in The Netherlands attracted attention due to its magnitude and duration. The current epidemic and the historical background of Q fever in The Netherlands are reviewed according to national and international publications. Seroprevalence studies suggest that ...
Clinical studies of Q fever vaccine have been undertaken with screening of volunteers for humoral and cellular immune reactivity to specific Q fever antigens. A rapid and simplified immunofluorescent procedure has been developed for serodiagnosis of Q fev...
The results of a WHO-assisted survey of the distribution of Q fever in 32 countries and an analysis of reports published to date indicate that Q fever exists in 51 countries on five continents. Q-fever infection was most often reported in man and the domestic ruminants, such as cattle, sheep, ...
PubMed Central
Q fever is a zoonosis caused by the bacterium Coxiella burnetii. One of the largest reported outbreaks of Q fever in humans occurred in the Netherlands starting in 2007; epidemiologic investigations identified small ruminants as the source. To determine the genetic background of C. burnetii in domestic ruminants ...
Chronic Q fever is characterized by deficient cell-mediated immune response, lack of granulomas, and dysregulation of the cytokine network. Altered transendothelial migration (TM) of peripheral-blood mononuclear cells might account for impaired immune response. TM of lymphocytes and monocytes was decreased in patients with Q ...
We describe an unusual presentation of Q fever with associated haemophagocytic syndrome, confirmed by bone marrow aspirate, Q fever polymerase chain reaction (PCR) and serological testing. Clinical recovery was observed after the commencement of doxycycline with normalisation of the patient's full blood count and ...
Q fever is a zoonotic infection caused by Coxiella burnetti, which has been previously regarded as an uncommon infectious disease in Korea but is sporadically reported recently. Common manifestations of acute Q fever usually present as influenza-like illness, pneumonia and occasionally hepatitis. Herein, we report ...
Nine countries of Central and Eastern Europe and five countries of Southeast Asia were investigated for the prevalence of Q fever. The disease is generally endemic and enzootic in Central and Eastern Europe, the evidence for this being substantial in Yugo...
Experiments on guinea pigs showed that two live vaccines - brucellosis and Q fever when applied subcutaneously and epidermally - are compatible and confer good immunity. The purpose of this work is to study the reactivity and immunologic effectiveness of ...
A 32-year-old woman with a past history of malignant melanoma presented with a lump in the upper left arm that was excised. Histological examination revealed a granulomatous dermatitis and panniculitis that proved to be a rare reaction to Q fever vaccination. PMID:15842410
Q fever, first reported in 1937, today exists in 51 countries on 5 continents. Therefore, it is important that medical and paramedical personnel be aware of this disease. Because of its resistance to various environmental conditions, the causative agent, ...
Contents: Characteristics of antibody accumulation dynamics in rusty and red voles with combined infections (tick-borne encephalitis and Q-rickettsiosis); Epidemiology of Crimean hemorrhagic fever. Report 1. Epidemiological characteristics of Crimean hemo...
The clinical diagnosis of Q fever is difficult. Whole cell antigens are currently used in several serological methods, but antigens are limited due to the hazardous nature of Coxiella burnetii cultivation. In this report, we described the method of detect...
Page 1. IFMMUNIZATION OF MAN 1eITH THE LIVE M-44 Q-FEVER VACCINE S' ~Translation ... 4a r'f Page 5. Reactogenicity of the live H-44 vaccine ...
In order to demonstrate the incidence of natural rickettsia infection, gamasid mites were usually examined in typical natural foci of Q fever where R. burneti strains were isolated from many animal species and from ixodid ticks. A total of 34 bioassays we...
Q-fever is a zoonotic infection. Pregnant women constitute a specific risk group as the infection may cause spontaneous abortion, intrauterine death, growth retardation, oligohydramnion and premature birth. A 39 year-old veterinarian had a spontaneous abortion in pregnancy week seven. During the first weeks of her pregnancy, she handled birth by-products from cows with ...
... BOTULINUM, BRUCELLOSIS, PROTECTIVE TREATMENTS, PLAGUES, Q FEVER, MELIOIDOSIS, MYCOTOXINS, VARIOLA VIRUS, TULAREMIA. ...
... Title : The Use of a Soluble Antigen of 'Rickettsia burneti' as an Allergen for Diagnosis of Fresh Cases of Q-Fever in Man. ...
... Title : THE VACCINAL PROCESS IN GUINEA PIGS SIMULTANEOUSLY IMMUNIZED WITH BRUCELLA AND Q-FEVER LIVE VACCINES,. ...
... The chemical composition studies were performed ... carbohydrates glucoronic acid, glucose and ... Q FEVER, AMINO ACIDS, ANTIGENS, ANTIBODIES ...
... Title : SIMULTANEOUS IMMUNIZATION OF HUMANS WITH LIVE BRUCELLOSIS AND Q FEVER VACCINES. Descriptive Note : Journal article. ...
... from Caochosloawk as well as foreign professional literature ... the titrations of specific anti- bodies are particularly ... changes in the body of guineia ...
... In 28.5% of the patients a weak albuminuria was detected, and in the pre- cipitate -- single leukocytes, erythrocytes and cells of renal epithelium. ...
... Title : Mixed Infections of Venezuelan Equine Encephalomyelitis and Q Fever in Macaca Mulatta Monkeys. Descriptive Note : Technical memo. ...
... Hybridoma antibodies were prepared in mice to Q fever antigens and assayed by FIAX and a new radioimmunoassay technique. ...
... Speech urgency. Leukopenia with a left shift rising from ... At onset, leukopenia 4800, increased to 6709; shift to the left and relative lymphocytosis. ...
... Following challenge, both strains of mice became infected, as characterized by rickettsemia, viable rickettsiae in the spleen, and serologic ...
... Title : EXPERIENCE ON THE MASS IMMUNIZATION OF HUMANS WITH THE M-44 LIVE VACCINE AGAINST Q-FEVER. REPT. ...
... Title : EXPERIENCE ON MASS IMMUNIZATION OF HUMAN BEINGS WITH THE M-44 LIVE VACCINE AGAINST Q-FEVER. ...
... Title : Comparison of Some Physical and Immuologic Properties of a Phase I and a Phase II Q Fever Vaccine in Guinea Pigs. ...
... Accession Number : AD0295815. Title : CLINICAL COURSE AND CERTAIN PROBLEMS OF DIFFERENTIAL DIAGNOSIS OF Q FEVER. ...
... or tularemia. In we1fu of the cases there was an accopanying bronchitis, in 5%v pneiumnia. ... respiration, indicated by the bronchitis and pneumonia. ...
Page 1. UNCLASSIFIED IN o AD 293' 213 ARMED SERVICES TECHNICAL INFORMATION AGENCY ARLINGTON HALL STATION ...
... onset of the disease; the maximum ... Descriptors : *Rickettsia, *Q fever, *Antigens, Humans ... Microorganisms, Infectious diseases, USSR, Translations ...
... '" Antigenic Structure of Coxiella burnetii 0) A Comparison of Lipopolysaccharide and Protein Antigens as Vaccines against Q Fever ...
... Title : Antigenic Structure of Coxiella burnetii: A Comparison of Lipopolysaccharide and Protein Antigens as Vaccines against Q Fever. ...
... Accession Number : AD0648094. Title : AN EXPERIMENTAL STUDY OF ENTERAL IMMUNIZATION WITH LIVE VACCINE AGAINST Q-FEVER. ...
PurposeIn 2007, a large goat-farming-associated Q fever outbreak occurred in the Netherlands. Data on the clinical outcome of Dutch Q fever patients are lacking. The current advocated follow-up strategy includes serological follow-up to detect evolution to chronic disease and cardiac screening at baseline to ...
The effectiveness of newer macrolides in acute Q fever for 113 patients was recorded. The mean times to defervescence were 2.9 days for doxycycline and 3.3, 3.9, 3.9, and 6.4 days for clarithromycin, roxithromycin, erythromycin, and ?-lactams, respectively (P < 0.01 for macrolides versus ?-lactams). We conclude that macrolides may be an adequate ...
Coxiella burnetii, the agent of Q fever, is a pathogen of vertebrates. In domestic animals, Q fever can cause abortion and reduced fertility. Infections in humans can be debilitating but are rarely fatal. House flies are vectors of Q fever in the laboratory, but infections ...
Technology Transfer Automated Retrieval System (TEKTRAN)
... M.D., director of the FDA�s Center for Devices and Radiological Health. �Q fever bacteria is considered a biothreat agent in ... City. For more information: FDA: Medical Devices FDA: Device Approvals and Clearances CDC: Q fever The FDA, an agency within the U.S. ...
Chronic Q fever can be difficult to diagnose because of a variety of non-specific clinical presentations. Chronic Q fever osteoarticular infections have rarely been reported in the literature. We describe here an unusual multifocal osteomyelitis due to Coxiella burnetii in an adult. PMID:21221701
, murine typhus fever and bubonic plague. The mosquito is involved in the transmission of malaria, dengue), parrot fever (or psittacosis), anthrax, plague, murine typhus, fever, relapsing fever, and tularemia. Vector-borne diseases constitute threats throughout the World. Examples are malaria, murine typhus ...
E-print Network
We describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats, the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to ...
Q or �query� fever is a zoonosis caused by the organism Coxiella burnetii. Cattle, sheep and goats are the most common reservoirs of this organism. The placenta of infected animals contains high numbers (up to 109/g) of C. burnetii. Aerosols occur at the time of parturition and man becomes infected following inhalation of the ...
To assess Q fever in France, we analyzed data for 1985-2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous ...
Large Q-fever outbreaks were reported in The Netherlands from May 2007 to 2009, with dairy-goat farms as the putative source. Since Q-fever outbreaks at such farms were first reported in 2005, we explored whether there was evidence of human outbreaks before May 2007. Space-time scan statistics were used to look for clusters of lower-respiratory infections ...
Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a ...
Background.?The importance of Q fever, spotted fever group rickettsiosis (SFGR), and typhus group rickettsiosis (TGR) as causes of febrile illness in sub-Saharan Africa is unknown; the putative role of Q fever as a human immunodeficiency virus (HIV) coinfection is unclear. Methods.?We ...
blisters, Stiffness, Fever, Unable to communicate. Procedure: Each subject was first briefed on the experi of WHICH virus occurred in Somalia in 1977? � Who received a state award for developing a Q fever weapon
Detailed metabolic balance studies were conducted in 76 volunteers during tularemia, sandfly fever, Q fever, or during investigations of variables pertinent to acute infection. With the onset of symptoms in each infection, the balance of nitrogen and othe...
... Leptospirosis was found in 40 (13.2%), malaria in 38 (12.5%), rickettsioses in 18 (5.9%), dengue fever in 16 (5.3%), Q fever in 15 (4.9 ...
... Leptospirosis was found in 40 (13.2%), malaria in 38 (12.5%), rickettsioses in 18 (5.9%), dengue fever in 16 (5.3%), Q fever in 15 (4.9%) brucellosis ...
An extensive survey of zoonotic diseases was conducted in the desert region of western Utah. Native mammals, birds and bloodsucking vectors were tested for evidence of Tularemia, plague, Q fever and Rocky Mountain spotted fever. Positive findings were cor...
Progress is reported in selected areas of research of the U. S. Army Medical Unit. Metabolic studies in volunteers infected with tularemia, sandfly fever and Q fever or maintained under conditions of artificial pyrexia are discussed. Successful isolation ...
agents of smallpox, yellow fever, psittacosis and Q fever. Applied Nicrobiology 8 (1) : 39-41 ; January 1960. HOFFMAN, R.K., H.M. Decker and C.R, Phillips. ...
NASA Website
An estensive epizoological survey of endemic diseases was conducted in the Great Salt Lake Desert region. Native mammals, birds and livestock were tested for Rocky Mountain spotted fever, Q fever, tularemia, plague and arboviruses. Susceptibility, transmi...
An extensive ecological and epizoological survey for endemic diseases was conducted in the Great Salt Lake Desert region. Native mammals, birds, and livestock were tested for Rocky Mountain spotted fever, Q fever, Tularemia, Brucella, and PLT group of org...
An extensive ecological and epizoological survey of endemic diseases was conducted in the Great Salt Lake Desert region. Native mammals, birds, and livestock were tested for Rocky Mountain spotted fever, Q fever, Tularemia, Brucella, Psittacosis, and Beds...
An extensive epizoological survey of endemic diseases was conducted in the great Salt Lkae Desert region. Native mammals, birds and livestock were tested for Rocky Mountain spotted fever, Q fever, tularemia and plague. e. Susceptibility, transmission and ...
... PubMed, CSAStephen, S. and K. N A. Rao. Q fever in South Kanara district: natural occurrence of Coxiella ... ...
NBII National Biological Information Infrastructure
Q fever is a zoonotic illness which frequently has a non-specific clinical presentation. Cases among deployed US military personnel have been reported in increasing numbers indicating an emerging at-risk occupational group. Banked serum specimens were utilized to estimate seroprevalence and risk factors among military personnel deployed to Iraq. Coxiella ...
Q fever is a zoonosis caused by Coxiella burnetii. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. This illness is associated with a wide clinical spectrum, from asymptomatic or mildly symptomatic seroconversion to fatal disease. ...
ABSTRACT: Q fever is a worldwide zoonosis caused by Coxiella burnetii. The disease most frequently manifests clinically as a self-limited febrile illness, as pneumonia (acute Q fever) or as a chronic illness that presents mainly as infective endocarditis. The extreme infectivity of the bacterium results in large ...
In the peak of the 2009 Q fever outbreak in the Netherlands, we introduced a diagnostic algorithm for acute Q fever with an enzyme-linked immunosorbent assay for immunoglobulin M antibodies to Coxiella burnetii phase II antigens (MII screen) as an initial step. Subsequently, an immunofluorescence assay or PCR was ...
Q fever in humans and coxiellosis in livestock are on the increase in Canada. The progressive spread of Coxiella burnetii takes place in the animal reservoirs of the rickettsia, mainly domestic ruminants. Human Q fever is a reverberation of the coxiellosis situation on our farms. Increasing animal concentration ...
The prevalence of antibodies against Coxiella burnetii and Toxoplasma gondii, the causative agents of Q fever and toxoplasmosis, was examined in goats to determine the extent of the potential of goats to tansfer these infections to persons. Of 1,054 goats from 234 premises in California, 248 goats (24%) were seropositive for C burnetii and 246 (23%) were ...
... of goat farms to human habitations; Factory farming- high density ... abortions occurred in the goat farms. Testing of ... Visiting an affected farm is highly correlated ...
Center for Biologics Evaluation and Research (CBER)
... However, in view of the fact that no surveys of domestic animals have been carried out in Thailand, final opinion concerning the primary source of ...
... noted otherwise, peripheral blood mononuclear cells (PBMCs) were prepared by density gradient centrifugation over Ficoll-Hypaque(Pharmaci, Inc ...
is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks, as well as some other animals. Infected animals shed...
Science.gov Websites
Q fever is a zoonosis with a worldwide distribution with the exception of New Zealand. The disease is caused by Coxiella burnetii, a strictly intracellular, gram-negative bacterium. Many species of mammals, birds, and ticks are reservoirs of C. burnetii in nature. C. burnetii infection is most often latent in animals, with persistent shedding of bacteria ...
... reported in the instances of Q fever in laundry Chickens and guinea pigs were used as test ani- workers (11) and in a veterinariari's wife who may ...
... Potential Diagnostic Markers for Q Fever ... by western blot analysis of whole cell lysate separated ... IgG by IFA against both phase I and phase II cells. ...
... skin reaction with the allergen from Rickettsia buretii vas ... with the ninth day of the disease (period of ... heeltbv persons or In those with other diseases. ...
... Title : IMMUNIZATION OF HUMANS WITH M-44 LIVE VACCINE AGAINST Q FEVER (IMMUNIZATSIYA LYUDEI ZHIVOI VAKTSIONI M-44 PROTIV ...
... which form foci only among wild vertebrates, while Q fever represents those forming independent foci also among farm and domestic animals. ...
... Cough, nausea, vomiting, myalgia, arthralgia, chest pain, hepatitis, and occasionally ... are symptoms that are also associated with acute Q fever [39,41 ...
Contents: Report on Q Fever Vaccine Studies; Demonstration of Viruses in Leukocytes by the Fluorescent Antibody Technique; Recovery of Viral Particles from Serum for Electron Microscopy; Effects of Ionizing Irradiation on the Immune Response to Venezuelan...
... AND YELLOW FEVER AND WITH KILLED CHOLEA CORPUSCULAR VACCID IN VARIOUS CONC�E�TATIONS -�,.. C*Q (~Translation No. ...
of infected animals. Other modes of transmission to humans, including tick bites, ingestion of unpasteurized milk or dairy products, and human to human transmission, are rare....