a-t 2015; 46: 100

Warning regarding Q fever from live cell therapy: The US Centers for Disease Control and Prevention (CDC) are currently reporting of several US citizens who underwent treatment with intramuscular injections of live cells in May 2014 in the state of Rhineland-Palatinate, Germany. The live cells consist of homogenised tissue from sheep foetuses and sheep and are offered as anti-ageing therapy or for treatment of degenerative diseases, among other conditions. Five individuals subsequently developed symptoms including fever, chills and headache and tested positive for Coxiella burnetii (1), the causative agent of Q fever. A Canadian woman who likewise received live cell therapy in May 2014 in Rhineland-Palatinate also contracted Q fever (2). Also in 2014, the German authorities received a report from a doctor in Munich of Q fever in a 79-year-old woman. She too had received live cell therapy in Rhineland-Palatinate. As the Paul-Ehrlich-Institut had only received a single report of diagnosed Q fever infection in Germany following injection of live cells up to the end of 2014, and given that in the USA and Canada together, a total of seven patients who received live cell therapy in Germany have been diagnosed with infection, we expect that there are significant numbers of unrecognised/unreported cases in Germany. Q fever is a zoonotic disease that starts with acute fever, chills, muscle pain and headache and which can have a serious course. Detection of Coxiella burnetii must be reported to the authorities. The treatment of choice is doxycycline (DOXY-CT and other generics) for two to three weeks (1). There is no proof of benefit of live cell therapy (1). Severe adverse effects such as anaphylaxis, vasculitis, encephalitis, polyradiculitis, infection, paresis and death have been documented (1). In Germany, it has been prohibited since 1997 to place on the market proprietary medicinal products with live cells for injection or infusion (3). On the basis of a constitutional complaint, however, the Federal Constitutional Court made it clear that doctors may use live cells which they prepare themselves and inject immediately (4). In light of the clearly negative harm-benefit balance, this potentially life-threatening quackery, which has gained currency since the 1930s, should be prohibited once and for all, -Ed.