Reemergence of Q Fever after 11 September 2001

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Abstract
For decades, Q fever has been forgotten as an infectious threat. It has been considered a disease of the past, especially in developed nations like the United States. However, since 2001, the disease has reemerged, as evidenced by the article by Spotts Whitney et al. in this issue of Clinical Infectious Diseases [1]. Reported cases of Q fever in the United States has increased by 6.5 fold from 26 cases in 2001 to 169 cases in 2006 [2]. The observed prevalence of an infectious disease, such as Q fever, is mainly dependent on 3 factors, the true prevalence, the quality of diagnostic tools used to evaluate the prevalence, and the amount of interest that physicians and epidemiologists focus on disease research. Changes in these 3 factors after the terrorist attack on the United States in 2001 have dramatically influenced the perceived prevalence of Q fever in the United States. After the classification of Coxiella burnetii as a class B potential bioweapon, the increased interest in Q fever by physicians and the subsequent commercialization of related serological assays have helped identify cases of US soldiers who acquired C. burnetii infection while in Southwest Asia (Iraq) [3].

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