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Q Fever is Underestimated in the United States: A Comparison of Fatal Q Fever Cases from Two National Reporting Systems

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  • Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Prion and Public Health Office, Centers for Disease Control and Prevention, Atlanta, Georgia

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.

Author Notes

* Address correspondence to F. Scott Dahlgren, Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS A-30, Atlanta, GA 30333. E-mail: iot0@cdc.gov

Authors' addresses: F. Scott Dahlgren and Jennifer H. McQuiston, Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, GA, E-mails: iot0@cdc.gov and fzh7@cdc.gov. Dana L. Haberling, Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Atlanta, GA, E-mail: fnj2@cdc.gov.

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