Military significance of Q fever: a review

Q fever is undoubtedly a disease of military significance. Whilst so far it has only been described in troops operating in Mediterranean countries, the Balkans and southern Europe, it is a potential hazard for nonindigenous soldiers in at least 51 countries on 5 continents. Sheep and goats are the main source of infection, and the disease is almost entirely acquired by inhalation of dust-borne rickettsiae from an environment contaminated with infected placentae. The commonest vehicle of transmission is infected hay and straw. On the available evidence, Q fever is simply and largely preventible as a significant military disease by implementation of the following measures: (I) Education on the source and methods of infection. (2) Banning the use of hay and straw for bedding, and the clearing and burning of hay and straw fromfarm buildings prior to occupation. (3) The exclusion of sheep and goats from military areas. (4) Regular serological surveillance of flocks adjoining military areas for evidence of heavy infection by Coxiella burnet;’ (5) Vigilance for an unusually high incidence of abortion in flocks adjoining military areas, which should initiate an immediate serological survey to determine the possibility of gross environmental contamination by the Q fever organism. (6) The possible use of short term prophylaxis with tetracycline for limited exposures to Q fever.