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NATIONAL SURVEILLANCE AND THE EPIDEMIOLOGY OF HUMAN Q FEVER IN THE UNITED STATES, 1978–2004

Although Q fever is considered enzootic in the United States, surveillance for human Q fever has been historically limited. From 1978 through 1999, 436 cases (average = 20 per year) of human Q fever were reported. After Q fever became nationally reportable in 1999, 255 human Q fever cases (average = 51 per year) were reported with illness onset during 2000 through 2004. The median age of cases was 51 years, and most cases were male (77%). The average annual incidence of Q fever was 0.28 cases per million persons, and was highest in persons 50–59 years of age (0.39 cases per million). State-specific incidence ranged from a high of 2.40 cases per million persons in Wyoming, to 0 cases in some states. Since Q fever became reportable, case reports have increased by more than 250%. Surveillance for Q fever is essential to establish the distribution and magnitude of disease and to complement U.S. bioterrorism preparedness activities.

Received November 16, 2005. Accepted for publication February 28, 2006.

Acknowledgments: We thank the state health departments who freely shared surveillance data.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agency.

^* Address correspondence to Jennifer H. McQuiston, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-03, Atlanta, GA 30333. E-mail: fzh7{at}cdc.gov

Authors’ addresses: Jennifer H. McQuiston, David Swerdlow, and Herbert A. Thompson, Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-03, Atlanta, GA 30333, Telephone: 404-639-1075, Fax: 404-639-2778, E-mail: fzh7{at}cdc.gov. Robert C. Holman, Office of the Director, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop A-39, Atlanta, GA 30333. Candace L. McCall, United States Air Force, Air Force Institute of Operational Health, Risk Assessment Division, 2513 Kennedy Circle, Brooks City-Base, TX 78235-5116, Telephone: 210-536-3471, Fax: 210-536-6841. James E. Childs, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, Room 600, PO Box 208034, New Haven, CT 06520.

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