Page 121 - Journal of Special Operations Medicine - Summer 2015

Table 1 Recommended Doxycycline Dosages for Q Fever Disclaimer
Recommended Dosage for Acute Q fever The views expressed in this publication are those of the
Doxycycline is the first-line treatment for children with author and do not reflect the official policy or position
severe illness of all ages and adults: of the Department of the Army, Department of Defense,
• Adults: 100mg twice a day or the US Government.
• Children <45kg (100 lb): 2.2mg/kg body weight given
twice a day
Patients should be treated for at least 3 days after the Disclosure
fever subsides and until there is evidence of clinical The author has nothing to disclose.
improvement. Standard duration of treatment is 2 to 3 wk.
Recommended Dosage for Chronic Q Fever Bibliography
• Adults: doxycycline, 100mg every 12 h; and
hydroxychloroquine, 200mg every 8 h Anderson AD, Baker TR, Littrell AC, et al. Seroepidemiologic sur-
vey for Coxiella burnetii among hospitalized US troops de-
Standard duration of treatment is 18 mo. ployed to Iraq. Zoonoses Public Health. 2011;58:276–283.
Anderson A, Bijlmer H, Fournier PE, et al. Diagnosis and man-
agement of Q fever—United States, 2013: recommendations
Importance in a Deployed Setting from CDC and the Q Fever Working Group. MMWR Re-
comm Rep. 2013;62:1–30.
According to the US Centers for Disease Prevention and Maurin M, Raoult D. Q fever. Clin Microbiol Rev. 1999;12:
518–553.
Control, approximately 200 cases of acute Q fever were Royal J, Riddle MS, Mohareb E, et al. Seroepidemiologic survey
reported in US personnel who had deployed to Iraq for Coxiella burnetii among US military personnel deployed
since 2003. Due to the often nonspecific nature of this to Southwest and Central Asia in 2005. Am J Trop Med Hyg.
illness of varying severity, this is likely an underestimate. 2013;89:991–995.
One seroepidemiologic survey of US military personnel US Centers for Disease Control and Prevention. Q fever. http://
stationed at Al Asad in Iraq showed that 7% serocon- www.cdc.gov/qfever/.
verted, for an incidence rate of more than 10 serocon-
versions per 1,000 person-months. A second and larger
study showed a seroconversion rate of 10%, which led COL Burnett is currently the Area Support Group-Kuwait
the authors to conclude that “Q fever is a significant in- Command Surgeon and is board-certified in Pediatrics and Pedi-
fectious disease threat to military personnel deployed to atric Infectious Diseases. He has served overseas in Korea, Ger-
Iraq.” American service members who serve in Iraq and many, Kosovo, Iraq, Afghanistan, Kuwait, and as the JSOTF-P
the Middle East should be considered at risk of infection Surgeon in the Philippines. He is a graduate of the University
for this disease, which is endemic to the region. of Wisconsin-Madison and the Medical College of Wisconsin.

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