Middle East DVEP - Armed Forces Pest Management Board

Haemaphysalis punctata is also widely distributed in Turkey, and all stages are found inpasture, shrub and forest zones. It too is a three-host tick, with larvae, nymphs and adultseach requiring a separate host. It is more resistant to desiccation than I. ricinus. Each ofits life stages remains attached to the host 1 to 2 days longer than I. ricinus. The numberof eggs deposited is similar to I. ricinus.Vector Surveillance and Suppression. Surveillance techniques for ixodid ticks arediscussed in TIM 26, Tick-Borne Diseases: Vector Surveillance and Control; and underLyme disease (page 129). Control of I. ricinus over large areas with acaricides isimpractical and environmentally unacceptable. In areas where viral transmission isendemic, personal protective measures must be used. Regular inspection to removeticks should be performed as often as practical. A formalin-inactivated cell culturevaccine is widely used in European countries. Vaccine efficacy approaches 97%;however, the FDA has not approved a vaccine for TBE.J. Q Fever. (Query fever)This is an acute, self-limiting, febrile rickettsial disease caused by Coxiella burnetii.Onset may be sudden with chills, headache and weakness. Pneumonia is the most seriouscomplication. There is considerable variation in severity and duration of illness.Infections may be inapparent or present as a nonspecific fever of unknown origin. Thecase fatality rate in untreated acute cases is less than 1%.Military Impact and Historical Perspective. Coxiella burnetii was originally describedfrom Australia in 1937. In ensuing years, C. burnetii was found to have a worldwidedistribution and a complex ecology and epidemiology. Thousands of cases of Q feveroccurred in US troops during World War I, and the disease caused epidemics in thearmies fighting during World War II. Three cases of Q fever were recorded in USmilitary personnel during the Persian Gulf War.Disease Distribution. Coxiella burnetii has been reported from at least 51 countries.Incidence is greater than reported because of the mildness of many cases. It iswidespread throughout the Middle East.Vector Ecology Profile. Several species of ixodid ticks transmit C. burnetii to animalsbut are not an important source of human infection.Transmission Cycle(s). In nature there are two cycles of infection with C. burnetii. Oneinvolves arthropods, especially ticks, and a variety of wild vertebrates. The other cycle ismaintained among domestic animals. Although humans are rarely, if ever, infected byticks, arthropods may transmit infection to domestic animals, especially sheep and cattle.Domestic animals have inapparent infections but shed large quantities of infectiousorganisms in their urine, milk, feces, and especially their placental products. BecauseC. burnetii is highly resistant to desiccation, light and extremes of temperature, infectiousorganisms become aerosolized, causing widespread outbreaks in humans and otheranimals, often at a great distance from place of origin. Dust in sheep or cattle sheds maybecome heavily contaminated. Once established, animal-to-animal spread of C. burnetii92