Clinician assessment for Coxiella burnetii infection in hospitalized patients with potentially compatible illnesses during Q fever outbreaks and following a health alert, Montana, 2011.

BACKGROUND Coxiella burnetii is an endemic bacterial pathogen in the United States and the causative agent of Q fever. Two outbreaks of Q fever occurred in Montana during 2011, which led to the issuance of a health alert urging clinicians to test patients with Q fever-compatible illnesses for C. burnetii infection. METHODS We retrospectively evaluated the medical records of patients hospitalized for fever, pneumonia, chest pain, and viral infection of unknown etiologies during the two Q fever outbreaks and following the health alert. RESULTS A total of 103 patients were included in the analysis. Clinicians assessed<1% of patients suffering illnesses compatible with Q fever for known risk factors or C. burnetii infection. Only 1 patient had Q fever excluded as a diagnosis. CONCLUSION Clinicians should assess for Q fever risk factors and consider the diagnosis in patients hospitalized with Q fever-compatible illnesses when the etiology of illness is unknown. Work is warranted to evaluate the effectiveness of current healthcare alert practices for zoonotic diseases.