title: Q fever in the United States: summary of case reports from two national surveillance systems, 2000-2012.
abstract: Q fever is a worldwide zoonosis historically associated with exposure to infected livestock. This study summarizes cases of Q fever, a notifiable disease in the United States, reported to the Centers for Disease Control and Prevention through two national surveillance systems with onset during 2000-2012. The overall incidence rate during this time was 0.38 cases per million persons per year. The reported case fatality rate was 2.0%, and the reported hospitalization rate was 62%. Most cases (61%) did not report exposure to cattle, goats, or sheep, suggesting that clinicians should consider Q fever even in the absence of livestock exposure. The prevalence of drinking raw milk among reported cases of Q fever (8.4%) was more than twice the national prevalence for the practice. Passive surveillance systems for Q fever are likely impacted by underreporting and underdiagnosis because of the nonspecific presentation of Q fever.
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia iot0@cdc.gov.
authors.forename: F Scott
authors.initials: FS
authors.lastname: Dahlgren
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: McQuiston
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Massung
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Alicia D
authors.initials: AD
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002417:Cattle / Q000382:microbiology; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D005260:Female; D006041:Goats / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D011778:Q Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012737:Sex Factors; D012756:Sheep / Q000382:microbiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology