Epidemiology of Q fever in Italy and in other Mediterranean countries

The history of Q fever in Italy may be divided into three periods: epidemic in character after the Second World War, endemic occurrence from 1960 to 1980, and sporadic occurrence at present. Clinical symptoms are unspecific, and diagnosis must be confirmed by serology and isolation of the causative agent. The reported incidence is consequently underestimated. Results are reported of a seroepidemiologic survey in animals and humans in the Italian region and western Sicily. In the Mediterranean area several epidemic foci are still present. The need of further studies to evaluate the incidence of Q fever and to shed more light upon the epidemiology of Coxiella burnetii infections is stressed.