title: Bichat guidelines for the clinical management of Q fever and bioterrorism-related Q fever.
abstract: Q fever is a zoonotic disease caused by Coxiella burnetii. Its interest as a potential biological weapon stems from the fact that an aerosol of very few organisms could infect humans. Another route of transmission of C. burnetii could be through adding it to the food supply. Nevertheless, C. burnetii is considered to be one of the less suitable candidate agents for use in a bioterrorist attack; the incubation is long, many infections are inapparent and the mortality is low. In the case of an intentional release of C. burnetii by a terrorist, clinical presentation would be similar to naturally occurring disease. It may be asymptomatic, acute, normally accompanied by pneumonia or hepatitis, or chronic, usually manifested as endocarditis. Most cases of acute Q fever are asymptomatic and resolve spontaneously without specific treatment. Nevertheless, treatment can shorten the duration of illness and decrease the risk of complications such as endocarditis. Post-exposure prophylaxis is recommended after the exposure in the case of a bioterrorist attack.
authors.affiliation: Task Force on Biological and Chemical Agent Threats, Public Health Directorate, European Commission, Luxembourg. philippe.bossi@psl.ap-hop-paris.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Bossi
authors.forename: Anders
authors.initials: A
authors.lastname: Tegnell
authors.forename: Agoritsa
authors.initials: A
authors.lastname: Baka
authors.forename: Frank
authors.initials: F
authors.lastname: Van Loock
authors.forename: Jan
authors.initials: J
authors.lastname: Hendriks
authors.forename: Albrecht
authors.initials: A
authors.lastname: Werner
authors.forename: Heinrich
authors.initials: H
authors.lastname: Maidhof
authors.forename: Georgios
authors.initials: G
authors.lastname: Gouvras
mesh_terms: D023482:Bioterrorism / Q000517:prevention & control* / Q000706:statistics & numerical data; D003140:Communicable Disease Control / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D005060:Europe; D005062:European Union; D006801:Humans; D011159:Population Surveillance / Q000379:methods*; D011778:Q Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*