BULGARIAN REPORT ON Q FEVER

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000700180423-1
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 3
• Document Creation Date: December 22, 2016
• Document Release Date: September 6, 2011
• Sequence Number: 423
• Publication Date: June 2, 1954
• Content Type: REPORT

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CLASSIFICATION co11FIDEWrIAL
CENTRAL INTELLIGENCE AGENCY RFPOP.T
INFORMATION FROM
FOREIGN DOCUMENTS OR RADIO BROADCASTS
COUNTRY Bulgaria
SUBJECT Scientific - Medicine, Q fever
HOW
PUBLISHED Bimonthly periodical
WHERE
PUBLISHED Sofia
DATE
PUBLISHED Sep-Oct 1953
LANGUAGE Bull;arian
CD NO.
DATE OF
DATE DIST. . 3U4E 1954
NO. OF PAGES 3
SUPPLEMENT TO
REPORT NO.
BULGARIAN REPORT Cl:: Q FEVER
Two diseases of different etiology, the virus disease influenza and the
rickettsia disease Q fever, care so similar in e idemiolo gy and s
that a separate consideration of their .ndividual aspects Jis necessary logy
in
order to enable us to differentiate between them.
Q fever appeared in Europe between 193) and 1?41. It was first noted in
the Balkans (Bulgaria and cuctern and southern Greece), where it affected
German occupation troops and oc urred in the form of an epidemic broncho-
pneumonic disease resembling influenza. The disease was described by Imm-
haeuser, Kalk, and Frobesius under the name of "Balkan Grippe." Caminopetros
of the Pasteur Institute at Athens succeeded in isolating the causative factor
of the disease. Dingel determined that this causative factor was Rickettsia
burneti. Dennig in 1947 identified the disease as Q fever. When the British
occupied Greece in 1944, cases of the disease occurred among them. Camino-
petros again established that the disease in question was Q fever.
Between 1943 and 1945, the disease affected American troops in Italy and
also the indigenous population.
In the opinion of some investigators, Q fever (which was originally dis-
covered in Queensland, Australia) was brought to the Mediterranean and Greece
by Australian troops, and was spread into Bulgaria, Rumania, and Yugoslavia by
German troops. On the other hand, Caminopetros expressed the opinion that the
disease was indigenous to Greece, I. c., it had existed there before the ar-
rival of Australian troops. Professor Meldolesi held the view that the dis-
ease was indigenous to Italy.
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According to Broesamlen, Q fever was observed in the USSR in 1142, with
outbreaks occurring in southern USSR, particularly in the Crimea. On the
basis of a personal communication made by M. P.) Chumakov, the disease
observed in the USSR was hemorrhagic fever rather than Q fever. Hemorrhagic
fever is a disease caused by a virus. Its occurrence had been established
by Chumakov elsewhere in the USSR as well.
In Switzerland, Q fever was described in the St. Galen district in 1937.
It has occurred in many places in Germany. In 1947, 50,0;0 cases were
recorded in Hessen. An epidemic of the disease, intermincled with influenza,
spread south into Baden and Wuerttemberr. Bicling established that the dis-
ease was Q fever and called the '.ttentlon of the government of Hessen to the
danger which threatened the country
Q fever has been recorded in every wart. of Europe except Scandinavia.
In Europe, as in Ameri-a, Australia, Asia, and Africa, Q fever is an indige-
nous, frequently o'-ucrie, disease, which waz ori,;inally mistaken for in-
fluenza. In view of th:?- differences which exist between the rickettsiae that
cause Q fever and other rir.kettsiac, and in view of the fact that Q fever is
but one disease and is raised by the identical microorganism, Bergos proposed
in 1948 that the names Rickettsia burneti for the causative factor of the
Australian and European Q fever and Rickettsia diapori-a for the causative
factor of American Q :ever he replaced with it single name, Coxiella burneti.
Q lever may be cporadic, endemic, or epidemic. The 1944-1945 epidemic
in southern Italy reached lake ,a,rda in the north, crossed the frontier into
eastern Switzerland in 1y47,i.nd spread to Wuerttemherg, southern Baden, and
central Germany in 194;? This was a single pandemic without a separation
into individual epidemics or the occurrence of intervals between individual
epidemics.
Prof E. Chllov asserts with justification that It is very difficult and
often impossible to distinguish between the c.l.inic;tl manifestations of Q fever
and those of influenza caused by the A or B virus, Confusion with other dis-
eases of the grippe type (e. F., pri :-try aty.;irril pneumonia) is also possible.
One of the characteristics !ist.inguishin; Q fever from virus influenza
is that Q fever does not have the tenden-y to spread rapidly. Biological
differentiation between virus pneumonia and Q fever can be achieved by the
complement-fixation reaction carried out on a !-lood sample taken from the
patient 14-21 days after the onset; of the fever. The reaction of agglutina-
tion at a low temperature to negative in cases of Q fever, positive in cases
of influenza. Guinea pigs or Syrian hamsters can be infected for diagnostic
purposes. This must he done within one week after the patient's infection
with the fever.
It has already been stated that Q fever occurred among German troops in
Bulgaria during World War II, when it was observed in Europe in general.
Among Bulgarians, Q fever was diagnosed for the first time by A. Mitov in
1949 in two cases at Plovdiv. Mitov's finding shows that Q fever has con-
tinued to exist in Bulgaria since 1)44, appearing in sporadic cases or per-
haps in an endemic form which was mistaken for virus influenza. Under the
circumstances, one must assume that Q fever is indigenous to Bulgaria just
as to Greece and Italy.
From the scientific and practical standpoints, it seemed of interest to
investigate the occurrence of q fever in Bulgaria and the interdependence
between the Q fever affecting humans and the rickettsiosis caused by Coxiella
burneti among domestic animals. The plan of scientific work for 1950 to be
done by the Institute of Microbiology, Bulgarian Academy of Sciences, included
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the following projects: (1) "Investigation of Queensland Fever (Balkan
Grippe) in Bulgaria," to be carried out by Prof St. Angelov, Academician;
Prof K. Chilov, Corresponding Member, Bulgarian Academy of Sciences;
Dr I,Kuyumdzhiyev; and Dr Panayotov. (2) "Investigation of Rickettsiosis
of Domestic Animals, Particularly of Goats, in Relation to Human Q Fever in
Bulgaria," to be carried out by Academician St. Angelov and Dr I Kuyumdzhiyev.
The investigations on these two subjects were continued through 1950-1952.
The serological method of complement fixation was applied in these investi-
gations.
Within 3 years, 270 human-blood samples were examined in the entire
country. Of these samples, 86 gave a positive reaction for fever, i.e.,
31.8%. As far as the infection among animals was concerned, investigations
were carried out at the Petrich and Panagyurizhte okoliyas (districts) in
locations where human Q fever had occurred. Out of h2 animal blood samples
examined, 11 gave a positive reaction, i.e., 28.1k. In Petrich Okoiiya,
where Q fever was parti-uiarly prevalent, 8 blood samples out of 37 gave a
positive reaction, i.e., 21.71. It was also established that a farmer who
drank the milk of an infected goat caught Q fever, that in another case a
medical practitioner was infected, and that. in a third case a clergyman who
had consumed the milk of a sick cow was infected with Q fever. This, Q
fever exists in Bulgaria among both humans and animals, and there is a
definite connection between the human disease and the infection among
animals.
In order to differentiate between Q fever and influenza pneumonia (which
resembles it clinically) the First Clinic of Internal Diseases of the V. Cher-
venkov Medical Academy studied 102 cases of atypical bronchial pneumonia dur-
ing the influenza epidemic of 1952. Serological investigation of the blood
by means of the complement-fixation reaction showed that 21.5-22,, of the
patients had Q fever. This result demonstrated the parallel occurrence of the
virus infection and the rickettsia disease during the same epidemic outbreak,
a fact which has already been observed in many places in Europe and America.
A discussion of this problem and a description of a rickettsial epidemic can
he found in the article, "On the Balkan Grippe in Bulgaria," published by
H. Chilov and Zografski in S'vremenna leditslna.
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