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Abnormal q12/23/2023 Asymptomatic infections followed by seroconversion have been reported in up to 60% of cases identified during outbreak investigations ( 6– 8). Although acute Q fever symptoms in humans vary, the condition typically is characterized by a nonspecific febrile illness, hepatitis, or pneumonia. burnetii phase II antigen is predominant and is higher than the response to the phase I antigen, whereas a chronic infection is associated with a rising phase I immunoglobulin G (IgG) titer. During an acute infection, an antibody response to C. Q fever has acute and chronic stages that correspond to two distinct antigenic phases of antibody response. Q fever infections in humans and animals have been reported from every world region except Antarctica ( 6). The national seroprevalence of Q fever is estimated to be 3.1% based on data from the National Health and Nutrition Examination Survey (2003–2004), and human infections have been reported from every state in the United States ( 5). Since then, reports of Q fever have increased, with 167 cases reported in 2008, an increase greater than ninefold compared with 2000, in which 17 cases were reported ( 4). Q fever was designated a nationally notifiable disease in the United States in 1999. No vaccine is available commercially in the United States. Laboratory diagnosis relies mainly on serology, and doxycycline is the most effective treatment for acute illness. Other modes of transmission to humans, including tick bites, ingestion of unpasteurized milk or dairy products, and human-to-human transmission, are rare ( 1). Infection in humans usually occurs by inhalation of bacteria from air that is contaminated by excreta of infected animals. The causative organism, Coxiella burnetii, is an intracellular bacterium that tends to infect mononuclear phagocytes but can infect other cell types as well. Q fever, first described in 1937, is a worldwide zoonosis that has long been considered an underreported and underdiagnosed illness because symptoms frequently are nonspecific, making diagnosis challenging ( 1– 3). These recommendations will be reviewed approximately every 5 years and updated to include new published evidence. The guidelines address treatment of acute and chronic phases of Q fever illness in children, adults, and pregnant women, as well as management of occupational exposures. This report provides the first national recommendations issued by CDC for Q fever recognition, clinical and laboratory diagnosis, treatment, management, and reporting for health-care personnel and public health professionals. Because many human infections result in nonspecific or benign constitutional symptoms, establishing a diagnosis of Q fever often is challenging for clinicians. No licensed vaccine is available in the United States. Transmission occurs primarily through inhalation of aerosols from contaminated soil or animal waste. Q fever, a zoonotic disease caused by the bacterium Coxiella burnetii, can cause acute or chronic illness in humans. Petersen, MD, Director.Ĭorresponding preparer: Alicia Anderson, DVM, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, 1600 Clifton Road, MS A-30, Atlanta, GA 30333. Bell, MD, Director and the Division of Vector-Borne Diseases, Lyle R. The material in this report originated in the National Center for Emerging and Zoonotic Infectious Diseases, Beth P. 1 National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GeorgiaĢ National Institute for Public Health and the Environment, The Netherlandsģ French National Center for the Study and Diagnosis of Q Fever, Faculté de Médecine, Marseille, FranceĤ Australian Rickettsial Reference Laboratory Foundation, Victoria, Australiaĥ Walter Reed National Military Medical Center, Washington, DCĦ Canisius-Wilhelmina Hospital, Nijmegen, The Netherlandsħ Dalhousie University, Nova Scotia, CanadaĨ Duke University Medical School, Durham, North Carolina
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