Background: Q fever was first described over fifty years ago. While in a proportion of cases there is a clear etiologic link to farm animals, their products, and fomites, in the majority of cases no such association is apparent, and the mode of infection is a mystery.
Methods: In this paper, we examine the reported incidence of Q fever in Israel since it was made notifiable in 1951, and in particular for the period 1981-1985, when special surveillance at national reference laboratories was carried out.
Results: Age and sex as well as urban-rural distributions suggest the influence of occupation, but in the large majority of cases mode of transmission was unknown.
Conclusions: If our knowledge concerning the etiology of Q fever in Israel, and the means of preventing it, is to be advanced, each case should be investigated assiduously to uncover risk factors for exposure, and sero-epidemiologic studies carried out to identify geographic or occupational groups differentially infected.