If patients who have spent time in Iraq or the Netherlands present with fever along with pneumonia or hepatitis, physicians in the United States should consider the possibility of Q fever in the differential diagnosis.
According to a health advisory from the Centers for Disease Control and Prevention (CDC), more than 200 cases of acute Q fever have been reported in US military personnel deployed to Iraq since 2003. Because several cases were reported after patients' active duty had ended, the CDC has advised that physicians be especially aware of potential Q fever in military personnel and civilian contractors to ensure prompt diagnosis and treatment.
Voelker R. Risk of Exposure to Q Fever Pathogen Boosted by Travel in Iraq or Netherlands. JAMA. 2010;303(23):2345. doi:10.1001/jama.2010.790