Volume 92, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Two national surveillance systems capturing reports of fatal Q fever were compared with obtained estimates of Q fever underreporting in the United States using capture–recapture methods. During 2000–2011, a total of 33 unique fatal Q fever cases were reported through case report forms submitted to the Centers for Disease Control and Prevention and through U.S. death certificate data. A single case matched between both data sets, yielding an estimated 129 fatal cases (95% confidence interval [CI] = 62–1,250) during 2000–2011. Fatal cases of Q fever were underreported through case report forms by an estimated factor of 14 and through death certificates by an estimated factor of 5.2.


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  1. Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, Limonard G, Marrie TJ, Massung RF, McQuiston JH, Nicholson WL, Paddock CD, Sexton DJ, 2013. Diagnosis and management of Q fever–United States, 2013: recommendations from CDC and the Q Fever Working Group. MMWR Recomm Rep 62: 130.
    [Google Scholar]
  2. National Center for Health Statistics, 2014. Public-Use Data Set Documentation: Mortality Data Set for ICD-10 2001–2011. Hyattsville, MD: National Center for Health Statistics.
    [Google Scholar]
  3. Arias E, Schauman WS, Eschbach K, Sorlie PD, Backlund E, 2008. The validity of race and Hispanic origin reporting on death certificates in the United States. Vital Health Stat 2 (148): 123.
    [Google Scholar]
  4. Chapman DG, 1951. Some Properties of the Hypergeometric Distribution with Applications to Zoological Sample Censuses. Berkeley, CA: University of California Press.
    [Google Scholar]
  5. Cormack RM, 1992. Interval estimation for mark-recapture studies of closed populations. Biometrics 48: 567576.[Crossref]
    [Google Scholar]
  6. Council of State and Territorial Epidemiologists, 1999. Placing Q Fever (Coxiella burnetii) Under National Surveillance in the United States Under the National Public Health Surveillance System (NPHSS). Position Statement.
  7. Council of State and Territorial Epidemiologists, 2007. Revision of the Surveillance Case Definition for Q Fever. Position Statement.
  8. Adams DA, Gallagher KM, Jajosky RA, Kriseman J, Sharp P, Anderson WJ, Aranas AE, Mayes M, Wodajo MS, Onweh DH, Abellera JP; Division of Notifiable Diseases, Healthcare Information OoSE, Laboratory Services CDC, 2013. Summary of notifiable diseases - United States, 2011. MMWR Morb Mortal Wkly Rep 60: 1117.
    [Google Scholar]
  9. Chao A, Pan HY, Chiang SC, 2008. The Petersen-Lincoln estimator and its extension to estimate the size of a shared population. Biom J 50: 957970.[Crossref]
    [Google Scholar]
  10. van der Hoek W, Hogema BM, Dijkstra F, Rietveld A, Wijkmans CJ, Schneeberger PM, Zaaijer HL, 2012. Relation between Q fever notifications and Coxiella burnetii infections during the 2009 outbreak in The Netherlands. Euro Surveill 17: 20058.
    [Google Scholar]
  11. Dahlgren FS, McQuiston JH, Massung RF, Anderson AD, 2015. Q fever in the United States: summary of case reports from two national surveillance systems, 2000–2012. Am J Trop Med Hyg 92: 247255.[Crossref]
    [Google Scholar]
  12. Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA, Candee AJ, Patterson NE, Massung RF, 2009. Seroprevalence of Q fever in the United States, 2003–2004. Am J Trop Med Hyg 81: 691694.[Crossref]
    [Google Scholar]
  13. Espey DK, Jim MA, Richards TB, Begay C, Haverkamp D, Roberts D, 2014. Methods for improving the quality and completeness of mortality data for American Indians and Alaska Natives. Am J Public Health 104 (Suppl 3): S286S294.[Crossref]
    [Google Scholar]

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  • Received : 08 Aug 2014
  • Accepted : 19 Sep 2014
  • Published online : 04 Feb 2015
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