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Am. J. Trop. Med. Hyg., 75(1), 2006, pp. 29-32
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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Q FEVER IN THE SOUTHERN CALIFORNIA DESERT: EPIDEMIOLOGY, CLINICAL PRESENTATION AND TREATMENT

LAWRENCE A. CONE*, NOEL CURRY, PHILLIP SHAVER, DAVID BROOKS, JAMES DEFORGE, AND BARBARA E. POTTS
Department of Medicine, Eisenhower Medical Center, Rancho Mirage, California; Department of Medicine, Palo Verde Hospital, Blythe, Bighorn Institute, Palm Desert, California

Despite the absence of a natural reservoir for Q fever in the desert of Southern California, six cases have been identified during the past 32 years. During that period of time, two areas have been used by northern sheep ranchers from Idaho and Wyoming to import sheep to an area in the Coachella Valley through 1985. Thereafter, because of housing development, the sheep area was moved to Blythe along the Colorado River. All but two of these patients probably acquired infection by Coxiella burnetii by living or working in close proximity to these grazing areas but not directly involved with the sheep. The shift of infected patients from the Coachella Valley to Blythe (100 miles distant) seems to support that supposition. All patients with acute Q fever developed antibodies primarily to phase II antigen, whereas the only person with chronic Q fever developed phase I antibodies. All patients presented with granulomatous hepatitis. One also had a pulmonary infiltrate, and the single individual with chronic Q fever also had a mitral valve prosthesis, although echocardiography could not define endocarditis. All patients with acute infections responded to 3–5 weeks of therapy with doxycycline, whereas the patient with chronic disease failed 3 years of therapy with combination regimens. Further studies at the Eisenhower Medical Center on the prevalence of infection in Blythe, CA, and elsewhere are anticipated.

Received July 31, 2005. Accepted for publication January 29, 2006.

* Address correspondence to Lawrence A. Cone, Eisenhower Medical Center, Probst Professional Building, Suite 308, 39000 Bob Hope Drive, Rancho Mirage, CA 92270. E-mail: laconemedico{at}aol.com

Authors’ addresses: Lawrence A. Cone, Noel Curry, Phillip Shaver, and Barbara E. Potts, Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA 92270, E-mail: laconemedico{at}aol.com. David Brooks, Department of Medicine, Palo Verde Hospital, Blythe, CA. James DeForge, Bighorn Institute, Palm Desert, CA.






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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.