Information for Public Health Officials

How to Contact the Rickettsial Zoonoses Branch at CDC

The general public and healthcare providers should first call 1-800-CDC-INFO (1-800-232-4636) for questions regarding RMSF and other rickettsial diseases. If a consultation with a CDC scientist specializing in rickettsial diseases is advised, your call will be appropriately forwarded.

For Questions About Select Agent Notification

Coxiella burnetii is a select agent subject to the select agentexternal icon regulations found in 42 CFR Part 73. For questions regarding a suspected select agent event please contact the Division of Select Agents and Toxins, 404-718-2000 (after hours 404-488-7100) or If intentional release is suspected, please contact CDC Emergency Operations Center (404-488-7100) and local law enforcement.

Surveillance Case Definition

  • Q fever is a nationally notifiable condition, and all Q fever cases should be reported to your state or local health department according to local laws.
  • As of January 1, 2009, Q fever infections are reported under distinct reporting categories (acute and chronic Q fever) described in the 2009 Q fever surveillance case definition.

2009 Q Fever Case Definition

Case Report Form

  • Confirmed and probable cases of Q fever are reported through the National Notifiable Disease Surveillance System; states are encouraged to submit additional information using the CDC Q fever Case Report Form (CRF) pdf icon[PDF – 3 pages].
  • This form collects additional important information that may not otherwise be reported to CDC, including how the diagnosis was made, and whether the patient was hospitalized or died.
  • If a different state-specific form is already used to collect this information, this information may be submitted to CDC in lieu of a CRF.

How to Submit Specimens for Q fever Testing

Who May Submit Specimens to CDC

  • Serum antibody tests for Q fever are available through some commercial and state public health labs. Routine testing should primarily use these testing options.
  • Samples may be sent to CDC for confirmatory testing or with special permission from the Rickettsial Zoonoses Branch through state health department.

State Health Departments

  • Specimens may be submitted to CDC for testing of rickettsial diseases, including Q fever.
  • For sample submission, please see instructions on the CDC Test Directory.

US Healthcare Providers

  • US healthcare providers should submit specimens through their health department for testing. Do not send specimens directly to CDC.
  • CDC policy requires that specimens be submitted through, or with the approval of, the provider’s state health department.
  • Please contact your state health department to assist you with specimen submission and reporting of an infected patient.
  • Final reports of test results are returned to the state public health laboratory who is responsible for providing these reports to the primary submitter.

For general questions about Q fever, please call 1-800-CDC-INFO (1-800-232-4636); public health officials or healthcare providers requiring an epidemiologic or clinical consultation will be forwarded appropriately to the epidemiologist on call. If you have questions about reporting a suspect case, please first consult your state health department.

Non-US Healthcare Providers

Non-US healthcare providers should consult CDC prior to submitting specimens for testing. For general questions about Q fever or other rickettsial diseases, please call 1-800-CDC-INFO (1-800-232-4636) or (888-232-6348). For specimen requirements and submission instructions, please see CDC Test Directory.

Laboratory Response Network

Laboratory testing plays the largest role in diagnosing patients Q fever and other bio-threat agents. The Laboratory Response Network (LRN) is a national network of local, state, and federal public health, food testing, veterinary diagnostic, and environmental testing laboratories that provide the laboratory infrastructure and capacity to respond to biological and chemical terrorism, and other public health emergencies.

The LRN was created through a partnership with the Department of Health and Human Services and the CDC, the Federal Bureau of Investigation (FBI), and the Association of Public Health Laboratories (APHL). This network links state and local public health laboratories in all states with clinical, military, veterinary, and agricultural labs as well as labs that test water and food. Together, these labs can quickly identify biological threats, including Q fever.

Which Laboratories Conduct the Tests?

Once specimens are collected, they are sent to a laboratory for testing. Each laboratory in the LRN has a different role in the testing of the specimen.
Sentinel labs: At this time, local clinical laboratories do not regularly perform testing for the presence of Coxiella burnetii, the bacteria that causes Q fever. Specimens requiring these tests are sent to a reference laboratory for testing.
Reference labs: Public health laboratories in state health departments and in large metropolitan areas can test for the presence of C. burnetii. If C. burnetii is present in a diagnostic sample (called a presumptive positive), the specimens are then sent to a national laboratory for confirmation.
National labs: CDC laboratories can conduct more sophisticated tests to confirm and describe the strain of C. burnetii in order to confirm infection with C. burnetii.