How is Q fever spread?

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Q fever spreads mainly through inhalation of aerosols containing Coxiella burnetii, the organism shed in birth products and other excreta of infected animals. Fresh or dried placental material, amniotic fluid, feces, urine, and even contaminated dust can release these aerosols into the air, which people then inhale. This is why exposure during birthing events in cattle, sheep, and goats is a common risk, and why unpasteurized milk can also transmit the bacterium, though inhalation of contaminated aerosols is the primary route. Tick bites can play a role in the animal life cycle, but they are not the main way humans acquire Q fever. Direct person-to-person transmission is extremely rare, and ingestion of contaminated water is not a typical route.