A case of person-to-person transmission of Q fever from an active duty serviceman to his spouse.

Coxiella burnetii has recently gained military relevance given its potential as a bioterrorism agent, and the multiple cases reported among U.S. military personnel deployed to the Middle East. Sexual transmission of Q fever is rare but has been reported in the literature. We describe the possible sexual transmission of Q fever from a returning serviceman from Iraq to his wife. In a recent editorial commentary, Dr. Raoult wrote about the reemergence of Q fever after September 11, 2001 (Raoult 2009). Indeed, C. burnetii has gained military relevance given its potential as a bioterrorism agent and the multiple cases reported among military personnel deployed in Southwest/Central Asia and North Africa (Botros et al. 1995 , Meskini et al. 1995 , Leung-Shea and Danaher 2006 ). Human serosurveys in these geographic areas have reported prevalence rates for Q fever ranging from 10% to 37% in contrast to the United States, which has an estimated Q fever seroprevalence of 3.1% (Botros et al. 1995, Meskini et al. 1995, Anderson et al. 2009). There is no data available for Q fever seroprevalence in Iraq. As a consequence, native populations in these regions may be more likely to possess immunity, and newcomers, such as U.S. military personnel, would be vulnerable to acute infection (Derrick 1973). We report on the possible sexual transmission of C. burnetii from a serviceman in the late recovery of acute Q fever to his wife.