{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:30:49Z","timestamp":1785267049143,"version":"3.55.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T00:00:00Z","timestamp":1391212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:p>\n                    In April, 2011, the Q fever bacterium\n                    <jats:italic toggle=\"yes\">Coxiella burnetii<\/jats:italic>\n                    was identified at a Washington farm where an abortion storm took place among goats. Soon after, Q fever cases were reported among visitors to the farm from Washington and Montana. A cross-sectional investigation was conducted among humans and goats associated with the index farm or with 16 other farms that purchased goats from the index farm or housed goats at the index farm for breeding purposes. Questionnaire data were analyzed, along with human and goat specimens collected for evidence of\n                    <jats:italic toggle=\"yes\">C. burnetii<\/jats:italic>\n                    infection. Twenty-one persons (19%) of the 109-person cohort from Washington and Montana met the outbreak case definition of an epidemiologic link to the index farm and a\n                    <jats:italic toggle=\"yes\">C. burnetii<\/jats:italic>\n                    Phase II immunoglobulin G (IgG) titer \u22651:128 by immunofluorescence assay. Seventy-one percent of cases (15 of 21) were symptomatic, compared with approximately 50% during previous Q fever outbreaks. National Q fever surveillance reports increase in frequency with age, but 29% (6 of 21) of cases during this outbreak occurred in children aged &lt;14 years. Goat-specific Q fever risk factors included direct contact with a newborn (prevalence ratio [PR] 10.7; confidence interval [CI] 1.5, 77.4), exposure to a newborn that died (PR 5.5; CI 1.7, 18.2), exposure to a weak newborn (PR 4.4; CI 1.7, 11.6), living on a property with goats (PR 4.2; CI 1.3, 13.9), and direct contact with birth\/afterbirth products (PR 2.8; CI 1.1, 6.9). Evidence of\n                    <jats:italic toggle=\"yes\">C. burnetii<\/jats:italic>\n                    infection was detected in all 17 goat herds sampled (13 Washington, 3 Montana, 1 Oregon) by PCR and\/or enzyme-linked immunosorbent assay. Following this investigation, Washington and Montana implemented a herd management plan to encourage best-management practices among livestock owners, reduce the potential for future outbreaks, and promote continued communication between state public health and agricultural authorities.\n                  <\/jats:p>","DOI":"10.1089\/vbz.2012.1202","type":"journal-article","created":{"date-parts":[[2013,12,18]],"date-time":"2013-12-18T10:59:04Z","timestamp":1387364344000},"page":"111-117","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":32,"title":["First Reported Multistate Human Q Fever Outbreak in the United States, 2011"],"prefix":"10.1177","volume":"14","author":[{"given":"Adam","family":"Bjork","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)","place":["Georgia"]},{"name":"Epidemic Intelligence Service","place":["Georgia"]},{"name":"Center for Global Health; CDC","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Marsden-Haug","sequence":"additional","affiliation":[{"name":"Washington State Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall J.","family":"Nett","sequence":"additional","affiliation":[{"name":"Office of Public Health and Preparedness","place":["Georgia"]},{"name":"Public Health and Safety Division"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert J.","family":"Kersh","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Gibson","sequence":"additional","affiliation":[{"name":"Public Health Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahnee","family":"Szymanski","sequence":"additional","affiliation":[{"name":"Montana Department of Livestock, Helena, Montana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Emery","sequence":"additional","affiliation":[{"name":"National Veterinary Services Laboratories","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kohrs","sequence":"additional","affiliation":[{"name":"Washington State Department of Agriculture"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Woodhall","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria","place":["Georgia"]},{"name":"Epidemic Intelligence Service","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia D.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,2,1]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2007.0104"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rvsc.2006.11.001"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1951.03810020026004"},{"key":"e_1_3_3_5_1","unstructured":"Council of State and Territorial Epidemiologists (CSTE). Position statement 09-ID-54: Public health reporting and national notification for Q fever. Atlanta: CSTE 2009. Available at http:\/\/c.ymcdn.com\/sites\/www.cste.org\/resource\/resmgr\/PS\/09-ID-54.pdf"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/16.2.282"},{"key":"e_1_3_3_7_1","first-page":"180","article-title":"A large outbreak of Q fever in the West Midlands: Windborne spread into a metropolitan area?","volume":"1","author":"Hawker JI","year":"1998","unstructured":"Hawker JI, , Ayres JG, , Blair I, , Evans MR, et al. A large outbreak of Q fever in the West Midlands: Windborne spread into a metropolitan area?. Commun Dis Public Health, 1998; 1:180\u2013187.","journal-title":"Commun Dis Public Health"},{"key":"e_1_3_3_8_1","first-page":"1692","article-title":"Chronic Q fever-related dual-pathogen endocarditis: Case series of three patients","volume":"49","author":"Kampschreur LM","year":"2011","unstructured":"Kampschreur LM, , Oosterheert JJ, , de Vries Feyens CA, , Delsing CE, et al. Chronic Q fever-related dual-pathogen endocarditis: Case series of three patients. J Microbiol, 2011; 49:1692\u20131694.","journal-title":"J Microbiol"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/380798"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10493-006-9025-2"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(02)00440-1"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(96)00369-X"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.75.1.0750036"},{"key":"e_1_3_3_14_1","first-page":"83","article-title":"An outbreak of Q fever in Bulgaria","volume":"45","author":"Panaiotov S","year":"2009","unstructured":"Panaiotov S, , Ciccozzi M, , Brankova N, , Levterova V, et al. An outbreak of Q fever in Bulgaria. 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