To assess if more rapid diagnosis and treatment is possible and to assess if this could be improved, since the first outbreak of Q fever in 2007.

Retrospective study of secondary data.

Analysis of surveillance data regarding Q fever over the period 2007 to 2009 and additional information on some patients from 2007 and 2008 obtained from general practitioners.

Diagnostic delay fell sharply between 2007 and 2009 and to a lesser extent, so did therapeutic delay from 2007 to 2008. In high incidence areas, diagnosis and treatment was faster with a lower proportion of patients admitted to hospital than in low incidence areas.

It appears that familiarity with the condition leads to faster diagnosis coupled with a lower percentage of hospital admissions. In order to react quickly it is necessary that doctor and patient should be aware of Q fever, especially in areas of low incidence. Polymerase chain reaction diagnostic techniques should also be available.