CDC warns of Q fever in Iraq, Netherlands

The CDC has issued a health advisory about increasing reports of Q fever in Iraq and the Netherlands. Physicians should consider Q fever in the differential diagnosis of patients who have traveled to those areas, the agency warned.

The most common clinical presentation of the disease is unexplained febrile illness, sometimes accompanied by pneumonia and/or hepatitis, although asymptomatic infections may also occur. Illness onset typically occurs within two to three weeks after exposure, according to the CDC advisory. The mortality rate for acute Q fever is 1% to 2%, and most patients with mild illness recover spontaneously within a few weeks, although antibiotic treatment will shorten the duration of illness and lessen the risk of complications. The primary mode of transmission of this zoonotic disease is inhalation of aerosols or dust contaminated by infected animals, most commonly cattle, sheep or goats.

Physicians seeing a patient—particularly military personnel or a civilian contractor—who has an illness consistent with Q fever and who has traveled to Iraq or the Netherlands within 30 days should perform appropriate laboratory testing. If a case of Q fever is probable or confirmed, a completed CDC Q fever case report form should be submitted to the state health department.