Chapter 19 : Q Fever

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Q Fever, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816490/9781555812386_Chap19-1.gif /docserver/preview/fulltext/10.1128/9781555816490/9781555812386_Chap19-2.gif


Q fever is a bacterial zoonosis caused by infection with . Mammals, birds, and ticks are natural hosts of the agent, which they persistently shed into the environment in their secretions, wastes, and products of parturition. Humans most often become infected by inhaling contaminated aerosols, especially those associated with the birth of domesticated animals and with dried tick feces. Although tick transmission of to various species of mammals is well documented, there are no confirmed occurrences of direct transmission to humans by feeding ticks. The organism is prevalent in a wide diversity of wild and domesticated animals, including sheep, goats, cattle, cats, dogs, and birds, and in the ticks that parasitize them. Several researchers have proposed that the continued maintenance of infections in domestic animals might depend upon introductions by tick species that act as bridging vectors from wild animal cycles. Much of the data on the occurrence of in ticks and vertebrate hosts, and on transmission between them, dates to descriptions of the ecology of Q fever published in the mid-20th century. This chapter discusses microbiology, ecology, epidemiology, clinical findings, and laboratory diagnosis of Q fever. It also presents treatment, prophylaxis, prevention, and decontamination of Q fever.

Citation: Thompson H, Dasch G, Dennis D. 2005. Q Fever, p 328-342. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch19

Key Concept Ranking

Q fever
Cardiovascular Diseases
Enzyme-Linked Immunosorbent Assay
Indirect Immunofluorescence Assay
Enzyme-Linked Immunosorbent Assay
Indirect Immunofluorescence Assay
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Abinanti, F. R. 1959. The varied epidemiology of Q fever infections, p. 914. In J. Smadel (ed.), Symposium on Q Fever. Medical science publication no. 6. Walter Reed Army Institute of Research, Government Printing Office, Washington, D.C.
2. Akporiaye, E. T.,, J. D. Rowatt,, A. A. Aragon,, and O. G. Baca. 1983. Lysosomal response of a murine macrophagelike cell line persistently infected with Coxiella burnetii. Infect. Immun. 40:11551162.
3. Amano, K.-I, J. C. Williams, S. R. Missler, and V. N. Reinhold. 1987. Structure and biological relationships of Coxiella burnetii lipopolysaccharides. J. Biol. Chem. 262:47404747.
4. Anigstein, L.,, and M. N. Bader. 1943. Investigation on rickettsial diseases in Texas. 4. Experimental study of Bullis fever. Tex. Rep. Biol. Med. 1:389409.
5. Babudieri, B. 1959. Q fever: a zoonosis. Adv. Vet. Sci. 5:81182.
6. Baca, O. G.,, and D. Paretsky. 1983. Q fever and Coxiella burnetii: a model for host-parasite interactions. Microbiol. Rev. 47:127149.
7. Bader, M. N.,, and L. Anigstein. 1944. Specificity of Bullis fever rickettsia. Tex. Rep. Biol. Med. 2:405412.
8. Bartlett, J. G. 2000. Commentary. Questions about Q fever. Medicine 79:124125.
9. Beaman, M.,, and J. Hung. 1989. Pericarditis associated with tick-borne Q fever. Aust. N. Z. J. Med. 19:254256.
10. Bell, J. A.,, M. D. Beck,, and R. J. Huebner. 1950. Epidemiologic studies of Q fever in Southern California. JAMA 142: 868872.
11. Bernier, R. D.,, T. Haney,, and D. Paretsky. 1974. Changes of lipid in liver and plasma during Q fever. Acta Virol. 18: 7580.
12. Bryne, W. R., 1997. Q fever. p. 523537. In F. R. Sidell,, E. T. Takafuji,, and D. R. Franz (ed.), Textbook of Military Medicine: Medical Aspects of Chemical and Biological Warfare. Borden Institute, Walter Reed Army Medical Center, Washington D.C. www.vnh.org/MedAspChemBioWar.
13. Buhariwalla, F.,, B. Cann,, and T. J. Marrie. 1996. Dogrelated outbreak of Q fever. Clin. Infect. Dis. 23:753755.
14. Burnet, F. M.,, and M. Freeman. 1937. Experimental studies of the virus of “Q” fever. Med. J. Aust. 2:299305.
15. Burton, P. R.,, N. Kordova,, and D. Paretsky. 1971. Electron microscopic studies of the rickettsia Coxiella burnetii: entry, lysosomal response and fate of rickettsial DNA in L cells. Can. J. Microbiol. 17:143150.
16.Centers for Disease Control and Prevention. 2000. Biological and chemical terrorism: strategic plan for preparedness and response. Recommendations of the CDC Strategic Planning Workgroup. Morb. Mortal. Wkly. Rep. 49(RR-4):114.
17.Centers for Disease Control and Prevention. Unpublished data.
18. Chen, S.-Y.,, M. H. Vodkin,, H. A. Thompson,, and J. C. Williams. 1990. Isolated Coxiella burnetii synthesizes DNA during acid activation in the absence of host cells. J. Gen. Microbiol. 136:8996.
19. Chong, A. K. H.,, J. La Brooy,, R. Norton,, and J. Masson. 2003. Q fever: a recent ‘outbreak’ in Townsville. Int. Med. J. 33:208210.
19a. Coleman, S. A.,, E. R. Fischer,, D. Howe,, D. J. Mead,, and R. A. Heinzen. 2004. Temporal analysis of Coxiella burnetii morphological differentiation. J. Bacteriol. 186:73447352.
20. Consigli, R. A.,, and D. Paretsky. 1962. Oxidation of glucose- 6-phosphate and isocitrate by Coxiella burnetii. J. Bacteriol. 83:206207.
21.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). CSTE position statement 1999-ID1. http://www.cste.org/ps/1999/1999-id-01.htm.
22. D’Angelo, L. J.,, E. F. Baker,, and W. Schlosser. 1979. Q fever in the United States, 1948-1977. J. Infect. Dis. 139:613615.
23. Davis, G. E. 1939. Rickettsia diaporica: recovery of three strains from Dermacentor andersoni collected in southeastern Wyoming. I. Their identity with Montana strain. Public Health Rep. 54:22192227.
24. Davis, G. E. 1940. Rickettsia diaporica: its persistence in the tissues of Ornithodoros turicata. Public Health Rep. 55:1862.
25. Davis, G. E. 1943. American Q fever: experimental transmission by the argasid ticks Ornithodoros moubata and Ornithodoros hermsi. Public Health Rep. 58:984987.
26. Davis, G. E.,, and H. Cox. 1938. A filter-passing infectious agent isolated from ticks. I. Isolation from Dermacentor andersoni, reaction in animals, and filtration experiments. Public Health Rep. 53:22592267.
27. De Rodaniche, E. C. 1949. Experimental transmission of Q fever by Amblyomma cajennense. Am. J. Trop. Med. 29:711714.
28. Derrick, E. H. 1937. “Q” fever, a new fever entity: clinical features, diagnosis, and laboratory investigation. Med. J. Aust. 2:281299.
29. Derrick, E. H.,, D. J. W. Smith,, H. E. Brown,, and M. Freeman. 1939. The role of the bandicoot in the epidemiology of “Q” fever: a preliminary study. Med. J. Aust. 1:150155.
30. Derrick, E. H.,, and D. J. W. Smith. 1940. Studies in the epidemiology of Q fever. 2. The isolation of three strains of Rickettsia burnetii from the bandicoot, Isodon torosus. Aust. J. Exp. Biol. Med. Sci. 18:99102.
31. Derrick, E. H.,, D. J. W. Smith,, and H. E. Brown. 1940. Studies in the epidemiology of Q fever. VI. The susceptibility of various animals. Aust. J. Exp. Biol. Med. Sci. 18:409413.
32. Derrick, E. H.,, D. J. W. Smith,, and H. E. Brown. 1942. Studies in the epidemiology of Q fever. IX. The role of the cow in the transmission of human infection. Aust. J. Exp. Biol. Med. Sci. 20:105110.
33. Derrick, E. H. 1944. The epidemiology of Q fever. J. Hyg. 43:357361.
34. Dyer, R. E. 1938. A filter-passing agent isolated from ticks. IV. Human infection. Public Health Rep. 53:22772282.
35. Ecklund, C. M.,, R. R. Parker,, and D. B. Lackman. 1947. A case of Q fever probably contracted by exposure to ticks in nature. Public Health Rep. 62:14131416.
36. Enright, J. B.,, W. W. Sadler,, and R. C. Thomas. 1957. Thermal inactivation of Coxiella burnetii and its relation to the pasteurization of milk. Public Health monograph No. 47, Public Health Service Publication No. 517. U.S. Government Printing Office, Washington, D.C.
37. Enright, J. B.,, C. E. Franti,, D. E. Behymer,, W. M. Longhurst,, V. J. Dutson,, and M. E. Wright. 1971. Coxiella burnetii in a wildlife-livestock environment. Distribution of Q fever in wild animals. Am. J. Epidemiol. 94:7990.
38. Fiset, P.,, and T. E. Woodward,. 1998. Q fever, p. 583593. In A. S. Evans, and P. S. Brachman (ed.), Bacterial Infections of Humans: Epidemiology and Control, 3rd ed. Plenum Medical Book Co., New York, N.Y.
39. Fishbein, D. B.,, and D. Raoult. 1992. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am. J. Trop. Med. Hyg. 47:3540.
40. Fournier, P. E.,, J. P. Casalta,, P. Piquet,, P. Tournigand,, A. Branchereau,, and D. Raoult. 1998. Coxiella burnetii infection of aneurysms or vascular grafts: report of seven cases and review. Clin. Infect. Dis. 26:116121.
41. Fraser, M. E.,, L. P. Mallavia,, J. E. Samuel,, and O. G. Baca. 1990. DNA probes for the identification of Coxiella burnetii strains. Ann. N. Y. Acad. Sci. 590:445448.
42. Gilroy, N.,, N. Formica,, M. Beers A. Egan, S. Conaty, and B. P. Marmion. 2001. Abattoir-associated Q fever: a Q fever outbreak during a Q fever vaccination program. Aust. N. Z. J. Public Health 25:362367.
43. Hackstadt, T.,, and J. C. Williams. 1981. Biochemical stratagem for obligate parasitism of eukaryotic cells by Coxiella burnetii. Proc. Natl. Acad. Sci. USA 78:32403244.
44. Hackstadt, T. 1983. Estimation of the cytoplasmic pH of Coxiella burnetii and effect of substrate oxidation on proton motive force. J. Bacteriol. 154:591597.
45. Harris, R. J.,, P. A. Storm,, A. Lloyd,, M. Arens,, and B. P. Marmion. 2000. Long-term persistence of Coxiella burnetii in the host after primary Q fever. Epidemiol. Infect. 124: 543549.
46. Hawker, J. I.,, J. G. Ayers,, I. Blair,, M. R. Evans,, D. L. Smith,, E. G. Smith,, P. S. Burge,, M. J. Carpenter,, E. O. Caul,, B. Coupland,, U. Desselberger,, I. D. Farrell,, P. J. Saunders,, and W. J. Wood. 1998. A large outbreak of Q fever in the West Midlands: windborne spread into a metropolitan area? Commun. Dis. Public Health 1:180187.
47. Heinzen, R. A.,, T. Hackstadt,, and J. E. Samuel. 1999. Developmental biology of Coxiella burnetii. Trends Microbiol. 7:149154.
48. Hellenbrand, W.,, T. Breuer,, and L. Petersen. 2001. Changing epidemiology of Q fever in Germany, 1947-1999. Emerg. Infect. Dis. 7:789796.
49. Ho, T.,, K. K. Htwe,, N. Yamasaki,, G. Q. Zhang,, M. Ogawa,, T. Yamaguchi,, H. Fukushi,, and K. Hirai. 1995. Isolation of Coxiella burnetii from dairy cattle and ticks, and some characteristics of the isolates in Japan. Microbiol. Immunol. 39:663671.
50. Hoover, T. A.,, D. W. Culp,, M. H. Vodkin,, J. C. Williams,, and H. A. Thompson. 2002. Chromosomal DNA deletions explain phenotypic characteristics of two antigenic variants, phase II and RSA 514 (Crazy), of the Coxiella burnetii Nine Mile strain. Infect. Immun. 70:67266733.
51. Huebner, R. J.,, and J. A. Bell. 1951. Q fever studies in southern California: summary of current results and discussion of possible control measures. JAMA 145:301305.
52. Huebner, R. J.,, W. J. Jellison,, and D. M. Beck. 1949. Q fever—a review of current knowledge. Ann. Intern. Med. 30:495509.
53. Hussein, A.,, E. Kovacova,, and R. Toman. 2001. Isolation and evaluation of Coxiella burnetii O-polysaccharide antigen as an immunodiagnostic reagent. Acta Virol. 45:173180.
54. Janbon, F.,, D. Raoult,, J. Reynes,, and A. Bertrand. 1989. Concomitant human infection due to Rickettsia conorii and Coxiella burnetii. J. Infect. Dis. 160:354355.
55. Kazar, J.,, and R. Brezina. 1991. Control of rickettsial diseases. Eur. J. Epidemiol. 7:282286.
56. Kordova, N. 1959. Filterable particles of Coxiella burnetii. Acta Virol. 3:2536.
57. Lackman, D. B.,, R. N. Philip,, E. A. Casper,, J. F. Bell,, J. B. Enright,, and E. G. Pickens. 1967. Q fever immunity in man. Health Lab. Sci. 4:236244.
58. Langley, J. M.,, T. J. Marrie,, A. Covert,, D. M. Waag,, and J. C. Williams. 1988. Poker player’s pneumonia; an urban outbreak of Q fever following exposure to a parturient cat. New Engl. J. Med. 319:354356.
59. LaScola, B.,, and D. Raoult. 2001. Survival of Coxiella burnetii within the free-living amoeba Acanthamoeba castellanii. Clin. Microbiol. Infect. 7:7579.
60. Lennette, E. H.,, and W. H. Clark. 1951. Observations of the epidemiology of Q fever in Northern California. JAMA 145:306309.
61. Lepidi, H.,, P. Houpikian,, Z. Liang,, and D. Raoult. 2003. Cardiac valves in patients with Q fever endocarditis: microbiological, molecular, and histologic studies. J. Infect. Dis. 187:10971106.
62. Liebisch, A. 1979. Ecology and distribution of Q-fever rickettsiae in Europe with special reference to Germany, p. 225231. Recent Advances in Acarology, vol. 2. Academic Press, New York, N.Y.
63. Lorenz, H.,, C. Jager,, H. Willems,, and G. Baljer. 1998. PCR detection of Coxiella burnetii from different clinical specimens, especially bovine milk, on the basis of DNA preparation with a silica matrix. Appl. Environ. Microbiol. 64: 42344237.
64. Lukacova, M.,, D. Valkova,, M. Q. Diaz,, D. Perecko,, and I. Barak. 1999. Green fluorescent protein as a detection marker for Coxiella burnetii transformation. FEMS Microbiol. Lett. 175:255260.
65. Luoto, L.,, J. F. Winn,, and R. J. Huebner. 1952. Q fever studies in southern California. XIII: Vaccination of dairy cattle against Q fever. Am. J. Hyg. 55:190202.
66. Luoto, L.,, and E. G. Pickens. 1961. A resume of recent research seeking to define the Q fever problem. Am. J. Hyg. 74:4349.
67. Lyytikainen, O.,, T. Ziese,, B. Schwartlander,, P. Matzdorff,, C. Kuhnen,, C. Jager,, and L. Petersen. 1998. An outbreak of sheep-associated Q fever in a rural community in Germany. Eur. J. Epidemiol. 14:193199.
68. Mak, D. B.,, D. E. Fry,, and M. K. Bulsara. 2003. Prevalence of the Q fever exposure in the Kimberley, Western Australia. Commun. Dis. Intell. 27:267271.
69. Mallavia, L. P. 1991. Genetics of rickettsiae. Eur. J. Epidemiol. 7:213221.
70. Marchette, N. J., 1982. Coxiella burnetii: its origin and distribution. p. 6595. In N. Marchette, and D. Stiller (ed.), Ecological Relationships and Evolution of the Rickettsiae, vol. 2. CRC Press, Boca Raton, Fla.
71. Marmion, B. P.,, and M. S. Harvey. 1956. The varying epidemiology of Q fever in the south-east area of Great Britain. I. In an urban area. J. Hyg. (Cambridge) 54:533546.
72. Marmion, B. P.,, and M. G. P. Stoker. 1950. Q fever in Great Britain. Epidemiology of an outbreak. Lancet 2:611616.
73. Marmion, B. P.,, and M. G. P. Stoker. 1958. The epidemiology of Q fever in Great Britain. Br. Med. J. 5100:809816.
74. Marmion, B. P.,, M. G. P. Stoker,, C. B. V. Walker,, and R. G. Carpenter. 1956. Q fever in Great Britain-epidemiological information from a serological survey of healthy adults in Kent and East Anglia. J. Hyg. 54:118140.
75. Marmion, B. P.,, R. A. Ormsbee,, M. Krykou,, J. Wright,, D. A. Worsick,, S. Cameron,, A. Esterman,, and B. Feery. 1984. Vaccine prophylaxis of abattoir associated Q fever. Lancet 8417:14111414.
76. Marmion, B. P.,, R. A. Ormsbee,, M. Krykou,, J. Wright,, D. A. Worsick,, A. A. Izzo,, A. Esterman,, B. Feery,, and R. A. Shapiro. 1990. Vaccine prophylaxis of abattoir-associated Q fever: eight years experience in South Australian abattoirs. Epidemiol. Infect. 104:275287.
77. Marrie, T. J.,, and D. Raoult,. 2005. Coxiella burnetii (Q fever), p. 2296^–2301. In G. Mandell,, J. Z. Bennett,, and R. Dolin (ed.) Principles of Infectious Diseases. Elsevier Churchill Livingstone, Philadelphia, Pa.
78. Marrie, T. J.,, J. Van Buren,, J. Fraser,, E. V. Haldane,, R. S. Faulkner,, J. C. Williams,, and R. T. Kwan. 1985. Seroepidemiology of Q fever among domestic animals in Nova Scotia. Am. J. Public Health 75:763766.
79. Marrie, T. J.,, and D. Raoult. 1997. Q fever—a review and issues for the next century. Int. J. Antimicrob. Agents 8:145161.
80. Maurin, M.,, P. Benoliel,, P. Bongrand,, and D. Raoult. 1992. Phagolysosomes of Coxiella burnetii-infected cell lines maintain an acidic pH during persistent infection. Infect. Immun. 60:50135016.
81. Maurin, M.,, and D. Raoult. 1999. Q fever. Clin. Microbiol. Rev. 12:518553.
82. McCaul, T. F.,, and J. C. Williams. 1981. Developmental cycle of Coxiella burnetii: structure and morphogenesis of vegetative and sporogenic differentiations. J. Bacteriol. 147: 10631076.
83. McCaul, T. F., 1991. Developmental cycle of Coxiella burnetii, p. 223258. In J. C. Williams, and H. A. Thompson (ed.), Q Fever: The Biology of Coxiella burnetii. CRC Press, Boca Raton, Fla.
84. McCaul, T. F.,, J. C. Williams,, and H. A. Thompson. 1991. Electron microscopy of Coxiella burnetii in tissue culture. Induction of cell types as products of developmental cycle. Acta Virol. 35:545556.
85. McDade, J. E.,, C. C. Shephard,, D. W. Fraser,, T. R. Tsai,, M. A. Redus,, and W. R. Dowdle. 1977. Legionnaire’s disease: isolation of a bacterium and demonstration of its role in other respiratory disease. New Engl. J. Med. 297:11971203.
86. McDiarmid, L.,, T. Petney,, B. Dixon,, and R. Andrews. 2000. Range expansion of the tick Amblyomma triguttatum triguttatum, an Australian vector for Q fever. Int. J. Parasitol. 30:791793.
87. McQuiston, J. H.,, and H. A. Thompson,. 2003. Coxiella burnetii (Q fever), p. 911913. In S. S. Long,, L. K. Pickering,, and C. G. Prober (ed.), Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Churchill Livingstone, New York, N.Y.
88. McQuiston, J. H.,, J. E. Childs,, and H. A. Thompson. 2002. Zoonoses update: Q fever. J. Am. Vet. Assoc. 221:796799.
89. McQuiston, J.,, and J. E. Childs. 2002. Q fever in humans and animals in the United States. Vector Borne Zoonotic Dis. 2:179191.
90. Mediannikov, O.,, L. Ivanov,, M. Nishikawa,, R. Saito,, Y. N. Sidelnidov,, N. I. Zdanovskaya,, I. V. Tarasevich,, and H. Suzuki. 2003. Molecular evidence of a Coxiella-like microorganism harbored by Haemaphysalis concinnae ticks in the Russian Far East. Ann. N. Y. Acad. Sci. 990:226228.
91. Milazzo, A.,, R. Hall,, P. A. Storm,, R. J. Harris,, W. Winslow,, and B. P. Marmion. 2001. Sexually transmitted Q fever. Clin. Infect. Dis. 33:399402.
92. Moos, A.,, and T. Hackstadt. 1987. Comparative virulence of intra- and interstrain lipopolysaccharide variants of Coxiella burnetii in the guinea pig model. Infect. Immun. 55: 11441150.
92a. Musso, D.,, M. Drancourt,, S. Osscini,, and D. Raoult. 1996. Sequence of quinolone resistance-determining region of the gyrA gene for clinical isolates and for an in vitro-selected quinolone-resistant strain of Coxiella burnetii. Antimicrob. Agents Chemother. 40:870873.
93. Musso, D.,, and D. Raoult. 1995. Coxiella burnetii blood cultures from acute and chronic Q-fever patients. J. Clin. Microbiol. 33:31293132.
94. Noguchi, H. 1926. A filter-passing virus obtained from Dermacentor andersoni. J. Exp. Med. 44:110.
95. Paretsky, D. 1990. The biology of Coxiella burnetii and the pathobiochemistry of Q fever and endotoxicosis. Ann. N. Y. Acad. Sci. 590:416421.
96. Paretsky, D.,, R. A. Consigli,, and C. M. Downs. 1962. Studies on the physiology of rickettsiae. III. Glucose phosphorylation and and hexokinase activity in Coxiella burnetii. J. Bacteriol. 83:538543.
97. Parker, R. R.,, and G. E. Davis. 1938. A filter-passing infectious agent isolated from ticks. II. Transmission by Dermacentor andersoni. Public Health Rep. 53:22672270.
98. Parker, R. R.,, and G. M. Kohls. 1943. American Q fever: the occurrence of Rickettsia diaporica in Amblyomma americanum in Eastern Texas. Public Health Rep. 58:15101511.
99. Peacock, M. G.,, R. N. Philip,, J. C. Williams,, and R. S. Faulkner. 1983. Serological evaluation of Q fever in humans: enhanced phase I titers of immunoglobulins G and A are diagnostic for Q fever endocarditis. Infect. Immun. 41:10891098.
100. Philip, C. B. 1943. Nomenclature of the pathogenic rickettsiae. Am. J. Hyg. 37:301309.
101. Philip, C. B. 1948. Comments on the name of the Q fever organism. Public Health Rep. 63:58.
102. Pope, J. H.,, W. Scott,, and R. Dwyer. 1960. Coxiella burnetii in kangaroos and kangaroo ticks in Western Queensland. Aust. J. Exp. Biol. 38:1728.
103. Raoult, D.,, P. Houpikian,, H. Tissot Dupont,, J. M. Riss,, J. Arditi-Djiane,, and P. Brouqui. 1999. Treatment of Q fever endocarditis. Comparison of 2 regimens containing doxycycline and ofloxacin or hydroxychloroquine. Arch. Intern. Med. 159:167173.
104. Raoult, D.,, H. Tissot-Dupont,, C. Foucalt,, J. Gouvernet,, P. E. Fournier,, E. Bernit,, A. Stein,, M. Nesri,, J. R. Harle,, and P. J. Weiller. 2000. Q fever 1985-1998. Clinical and epidemiological features of 1,383 infections. Medicine 79:109123.
105. Rehacek, J.,, and I. V. Tarasevich. 1988. Coxiella burnetii, p. 204343. In Acari-Borne Rickettsiae and Rickettsioses in Eurasia. Veda Publishing House, Slovak Academy of Sciences, Bratislava, Slovakia.
106. Robbins, F. C.,, R. L. Gauld,, and F. B. Warner. 1946. Q fever in the Mediterranean area: report of its occurrence in allied troops. II. Epidemiology. Am. J. Hyg. 44:2350.
107. Robbins, F. C.,, R. Rustigian,, M. J. Snyder,, and J. E. Smadel. 1946. Q fever in the Mediterranean area: report of its occurrence in Allied troops. III. The etiological agent. Am. J. Hyg. 44:5163.
107. Rolain, J. M.,, F. Gourier,, P. Brouqui,, D. Larrey,, F. Jaubon,, S. Vene,, V. Jernestr,, and D. Raoult. 2005. Concomitant or consecutive infection with Coxiella burnetii and tickborne diseases. Clin. Infect. Dis. 40:8288.
108. Rosenberg, M.,, and N. Kordova. 1960. Study of intracellular forms of Coxiella burnetii in the electron microscope. Acta Virol. 4:5255.
109. Schramek, S.,, J. Radziejewska-Lebrecht,, and H. Mayer. 1985. 3-C-Branched aldoses in lipopolysaccharide of phase I Coxiella burnetii and their role as immunodominant factors. Eur. J. Biochem. 148:455461.
110. Scott, G. H.,, T. F. McCaul,, and J. C. Williams. 1989. Inactivation of Coxiella burnetii by gamma irradiation. J. Gen. Microbiol. 135:32633270.
111. Scott, G. H.,, and J. C. Williams. 1990. Susceptibility of Coxiella burnetii to chemical disinfectants. Ann. N. Y. Acad. Sci. 590:291296.
112. Seshadri, R.,, L. R. Hendrix,, and J. E. Samuel. 1999. Differential expression of translational elements by life cycle variants of Coxiella burnetii. Infect. Immun. 67:60266033.
113. Seshadri, R.,, I. T. Paulsen,, J. A. Eisen,, T. D. Read,, K. E. Nelson,, W. C. Nelson,, N. L. Ward,, H. Tettelin,, T. M. Davidsen,, M. J. Beanan,, R. T. Deboy,, S. C. Daugherty,, L. M. Brinkac,, R. Madupu,, R. J. Dodson,, H. M. Khouri,, K. H. Lee,, H. A. Carty,, D. Scanlan,, R. A. Heinzen,, H. A. Thompson,, J. E. Samuel,, C. M. Fraser,, and J. F. Heidelberg. 2003. Complete genome sequence of Coxiella burnetii. Proc. Natl. Acad. Sci. USA 100:54555460.
114. Sigel, M. M.,, T. F. M. Scott,, and W. Henle. 1950. Q fever in a wool and hair processing plant. Am. J. Public Health 40: 424532.
115. Smith, D. J. W. 1940. Studies in epidemiology of Q fever. III. The transmission of Q fever by the tick Haemaphysalis humerosa. Aust. J. Exp. Biol. Med. Sci. 18:103118.
116. Smith, D. J. W. 1941. Studies in the epidemiology of Q fever. VIII. The transmission of Q fever by the tick, Rhipicephalus sanguineus. Aust. J. Exp. Biol. Med. Sci. 19:133136.
117. Smith, D. J. W. 1942. Studies in the epidemiology of Q fever. X. The transmission of Q fever by the tick Ixodes holocyclus (with notes on the paralysis in bandicoots). Aust. J. Exp. Biol. Med. Sci. 20:213217.
118. Smith, D. J. W. 1942. Studies in the epidemiology of Q fever. XI. Experimental infection of the ticks, Haemaphysalis bispinosa and Ornithodoros sp., with Rickettsia burnetii. Aust. J. Exp. Biol. Med. Sci. 20:295296.
119. Smith, D. J. W.,, and E. H. Derrick. 1940. Studies in the epidemiology of Q fever. 1. The isolation of six strains of Rickettsia burnetii from the tick Haemaphysalis humerosa. Aust. J. Exp. Biol. Med. Sci. 18:18.
120. Spyridaki, I.,, A. Psaroulaki,, F. Loukaides,, M. Antoniou,, C. Hadjichristodolou,, and Y. Tselentis. 2002. Isolation of Coxiella burnetii by a centrifugation shell-vial assay from ticks collected in Cyprus: detection by nested PCR and by PCR-restriction fragment length polymorphism analyses. Am. J. Trop. Med. Hyg. 66:8690.
121. Stein, A.,, and D. Raoult. 1992. Detection of Coxiella burnetii by DNA amplification using the polymerase chain reaction. J. Clin. Microbiol. 30:24622466.
122. Steinhaus, E. A.,, and R. R. Parker. Unpublished observations, 1943-1944. Unpublished data.
123. Stoenner, H. G.,, R. Holdenreid,, D. Lackman,, J. S. Orsborn, Jr. 1959. The occurrence of Coxiella burnetii, Brucella, and other pathogens among fauna of the Great Salt Lake Desert in Utah. Am. J. Trop. Med. Hyg. 8:590596.
124. Stoker, M. G. P.,, and P. Fiset. 1956. Phase variation in the Nine Mile and other strains of Rickettsia burnetii. Can. J. Microbiol. 2:310321.
125. Suhan, M.,, S.-Y. Chen,, H. A. Thompson,, T. A. Hoover,, A. Hill,, and J. C. Williams. 1994. Cloning and characterization of an autonomous replication sequence from Coxiella burnetii. J. Bacteriol. 176:52335243.
126. Suhan, M.,, S.-Y. Chen,, and H. A. Thompson. 1996. Transformation of Coxiella burnetii to ampicillin resistance. J. Bacteriol. 178:27012708.
127. Syrucek, L.,, O. Sobeslavsky,, and I. Gutvirth. 1958. Isolation of Coxiella burnetii from human placentas. J. Hyg. Epidemiol. 2:2935.
128. Thompson, H. A.,, T. A. Hoover,, M. H. Vodkin,, and E. I. Shaw. 2003. Do chromosomal deletions in the lipopolysaccharide biosynthetic regions explain all cases of phase variation in Coxiella burnetii strains? Ann. N. Y. Acad. Sci. 990:664670.
129. Tigertt, W. D., 1959. Studies on Q fever in man, p. 3946. In J. Smadel (ed.), Symposium on Q fever. Medical science publication no. 6. Commission on Rickettsial Diseases, Walter Reed Army Institute of Research, Washington, D.C.
130. Tigertt, W. D.,, A. S. Benenson,, and W. S. Gochenour. 1961. Airborne Q fever. Bacteriol. Rev. 25:285293.
131. Tissot-Dupont, H.,, S. Torres,, M. Nezri,, and D. Raoult. 1999. Hyperendemic focus of Q fever related to sheep and wind. Am. J. Epidemiol. 150:6774.
132. Toman, R., 1999. Lipopolysaccharides from virulent and lowvirulent phases of Coxiella burnetii, p. 8491. In D. Raoult, and P. Brouqui (ed.), Rickettsiae and Rickettsial Diseases at the Turn of the Third Millennium. Elsevier Press, Amsterdam, The Netherlands.
133. Toman, R.,, L. Skultety,, P. Ftacek,, and M. Hricovini. 1998. NMR study of virenose and dihydrohydroxystreptose isolated from Coxiella burnetii phase I lipopolysaccharide. Carbohydr. Res. 306:291296.
134. Topping, N. H.,, C. C. Shepard,, and J. V. Irons. 1947. Q fever in the United States. I. Epidemiologic studies of an outbreak among stock handlers and slaughterhouse workers. JAMA 133:813815.
135. Vest, E. D.,, D. L. Lundgren,, D. D. Parker,, D. E. Johnson,, E. L. Morse,, J. B. Bushman,, R. W. Sidwell,, and B. D. Thorpe.1965. Results of a five-year survey for certain enzootic diseases in the fauna of western Utah. Am. J. Trop. Med. Hyg. 14:124135.
136. Vodkin, M. H.,, and J. C. Williams. 1986. Overlapping deletion in two spontaneous phase variants of Coxiella burnetii. J. Gen. Microbiol. 132:25872594.
137. Waag, D. M.,, J. C. Williams,, M. G. Peacock,, and D. Raoult,. 1991. Methods of isolation, amplification, and purification of Coxiella burnetii, p. 8491. In J. C. Williams, and H. A. Thompson, (ed.), Q Fever: The Biology of Coxiella burnetii. CDC Press, Boca Raton, Fla.
138. Walker, D. H., 1988. Pathology of Q fever, p. 1727. In David Walker (ed.), Biology of Rickettsial Diseases, vol. 2. CRC Press, Boca Raton, Fla.
139. Weibe, M.,, P. R. Burton,, and D. M. Shankel. 1972. Isolation and characterization of two cell types of Coxiella burnetii phase I. J. Bacteriol. 110:368377.
140. Welsh, H. H.,, E. H. Lennette,, F. R. Abinanti,, and J. F. Winn. 1951. Q fever in California. IV. Occurrence of Coxiella burnetii in the placenta of naturally infected sheep. Public Health Rep. 66:14731477.
141. Welsh, H. H.,, E. H. Lennette,, and F. R. Abinanti. 1958. Airborne transmission of Q fever: the role of parturition in the generation of infective aerosols. Ann. N. Y. Acad. Sci. 70:528540.
142. Williams, J. C., 1991. Infectivity, virulence, and pathogenicity of Coxiella burnetii for various hosts, p. 2171. In J. C. Williams, and H. A. Thompson (ed.), Q Fever: The Biology of Coxiella burnetii. CDC Press, Boca Raton, Fla.
143. Zdrodovskii, P. F.,, and H. M. Golinevich. 1960. Q fever, p. 372423. In The Rickettsial Diseases, Pergamon Press, New York, N.Y.
144. Zhang, G. Q.,, S. V. Nguyen,, H. To,, M. Ogawa,, A. Hotta,, T. Yamaguchi,, H. J. Kim,, H. Fukushi,, and K. Hirai. 1998. Clinical evaluation of a new PCR assay for detection of Coxiella burnetii in human serum samples. J. Clin. Microbiol. 36:7780.
145. Zhang, G. Q.,, H. To,, T. Yamaguchi,, H. Fukushi,, and K. Hirai. 1997. Differentiation of Coxiella burnetii by sequence analysis of the gene (com1) encoding a 27-kDa outer membrane protein. Microbiol. Immunol. 41:871877.
146. Zuerner, R. L.,, and H. A. Thompson. 1983. Protein synthesis by intact Coxiella burnetii cells. J. Bacteriol. 156:186191.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error