Notification data and criteria during a large Q-fever epidemic reassessed

Abstract

From 2007 to 2010, the largest reported Q-fever epidemic occurred in the Netherlands with 4026 notified laboratory-confirmed cases. During the course of the epidemic, health-seeking behaviour changed and awareness among health professionals increased. Changes in laboratory workflows were implemented. The aim of this study was to analyse how these changes instigated adjustments of notification criteria and how these adjustments affected the monitoring and interpretation of the epidemic. We used the articles on laboratory procedures related to the epidemic and a description of the changes that were made to the notification criteria. We compared the output of a regional laboratory with notifications to the regional Public Health Service and the national register of infectious diseases. We compared the international notification criteria for acute Q-fever. Screening with ELISA IgM phase II and PCR was added to the diagnostic workflow. In the course of the epidemic, serology often revealed a positive IgG/IgM result although cases were not infected recently. With increasing background seroprevalence, the presence of IgM antibodies can only be suggestive for acute Q-fever and has to be confirmed either by seroconversion of IgG or a positive PCR result. Differences in sero-epidemiology make it unlikely that full harmonisation of notification criteria between countries is feasible.

Research Trends and Hotspots of Q Fever Research: A Bibliometric Analysis 1990‐2019

“…These articles were presented in 14 different languages. English, with 92% of the 2,840 Q fever articles, was the most used language followed by German (83 articles), French (67 articles), Spanish [ 29 ], Russian [ 14 ], Dutch [ 10 ], Czech [ 7 ], Italian [ 6 ], Hungarian [ 5 ], Turkish [ 5 ], Portuguese [ 4 ], Polish [ 3 ], Japanese [ 2 ], and Ukrainian [ 1 ]. Non-English articles had less citations, with CPP 2019 of 5.0, while English articles had CPP 2019 of 22.…”

“…Q fever is recognized as a global zoonotic disease that has been declared as potential bioterrorism category B select agent by the Centre for Disease Control and Prevention (CDC) [ 1 ]. It is regarded as a reportable disease in some countries [ 2 ]. This disease is caused by Coxiella burnetii , an obligate Gram-negative bacterium, which can infect human, various animals such as ruminants (cattle, goat, and sheep), pets, birds, ticks, and rarely reptiles and marine mammals [ 3 ].…”

Q fever seroprevalence in parturient women: the EQRUN cross-sectional study on Reunion Island

“…Further dilutions were chosen to discriminate recent or active infections from past or prevalent infections (IgG2 < 1:128 and IgM2 < 1: 48) and classify these as either possible (IgG2 = 1:128 and/or IgM2 ≥ 1:48), or probable (IgG2 ≥ 1:256 whatever IgM level). The use of phase 2 IgM alone were deemed only suggestive of recent infection and did not enter in the case definitions, as recommended by Netherlands experts [17]. These thresholds were chosen conservative to fulfil the National Reference Centre requirements and minimize the false positives [18].…”

Unutulan Bi̇r Zoonoti̇k Hastalik; Q Ateşi̇

“…İlk defa 1934 yılında Avustralya'dan Derrick ve Burnet tarafından, kenelerle bulaşan bir riketsia hastalığı olarak tanımlanır ve soru-bilinmeyen ateş anlamında Q ateşi olarak adlandırılır (5)(6)(7)(8)(9). Daha sonra Amerika ve ikinci dünya savaşı yıllarında Almanya, Yunanistan ve balkan ülkelerinden atipik pnomöniler şeklinde tanımlanmıştır (3,5,(10)(11)(12).…”

“…Klinik olarak q ateşinin genelde soğuk algınlığı tablosunda başlayıp pnömoni, hepatit ve nörolojik bulgularla görüldüğü bilinmesine rağmen fatal seyreden tablosu oldukça nadir bildirilmiştir (1,(33)(34)(35)(36). İhmal edilen bir zoonotik hastalık olan q ateşi değişik klinik formları ile birçok organ sistemini tutabilir (11,21,37,38).…”