Q Fever Outbreaks in Dalmatia, Croatia

The aim of the study was to describe the clinical and epidemiological features of the first greater outbreaks of Q fever in Dalmatia, Croatia. In 2003, January to April, 97 patients with Q fever pneumonia were hospitalized in three Dalmatian hospitals - Zadar, Sibenik and Split. In 2004, January to May, the outbreak involved 100 hospitalized patients. Many cases were epidemiologically connected and came from the well-known endemic foci but a number of sporadic cases among strictly urban population was also noted. During the outbreaks period antibodies to Coxiella burnetii were detected in 10.8% of 1378 domestic animals from the main foci. Since during this period nothing unusual happened in the sheep and goat flocks and in the windborne spread of coxiella spores, other risk factors may have contributed to these changes.