Q Fever in an Urban Area

Salmon, M.M.; Howells, B.; Glencross, E.J.G.; Evans, Alexandra; Palmer, Sam

doi:10.1016/s0140-6736(82)92000-1

Cited by 102 publications

(48 citation statements)

References 4 publications

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“…These associations were consistent with previously reported sources of C. burnetii infection, which have included the products of conception and contaminated straw and dust [6][7][8][9][10][11][14][15][16][17][18][19][20][21]. Although the school goat kidded in April-July 1987, well before the identification of the school outbreak, symptoms predated diagnosis of Q fever in all clinical cases.…”

Section: Discussionsupporting

confidence: 88%

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An epidemiological study of an outbreak of Q fever in a secondary school

1990

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SUMMARYFive cases of clinical Q fever were identified amongst students and staff of a Somerset secondary school between 23 October 1987 and 21 December 1987. Five goats which were kept at the school were found to have antibodies to Coxiella burnetii phase II.A cross-sectional study was conducted at the school in July 1988. A single CF test was used to identify evidence of prior infection, and a self-administered questionnaire was used to collect data on exposure variables and illness during 1987.Four hundred and ninety-nine eligible subjects took part in the study, and serological information was obtained from 461 of these. Eighty-seven subjects (18-9 %) had CF titres of 20 or greater. It was estimated that only 1 in every 30 individuals with evidence of past C. burnetii infection had been recognized as a clinical case of Q fever.Antibody positive subjects were more likely to have been off school sick and to report having suffered chest pain than negative subjects.Contact with school animals, specifically cleaning the school poultry, collecting their eggs and visiting a school goat on the day of kidding, was associated with the presence of antibodies to C. burnetii. However a large proportion of the antibody positives (24-2%) had no known contact with the school animals. Spread of organisms, either wind-borne or in straw or manure, may have been responsible for the high prevalence of unexplained infection. INTRODUCTION Q fever is a zoonosis caused by the rickettsia Coxiella burnetii. Human cases occur sporadically and in outbreaks primarily as a result of direct or indirect contact with infected animals or their products [1,2]. The infection is widespread amongst animal species including cattle, sheep and goats and is also seen in dogs, cats, birds and ticks. Serological surveys suggest that 2-3 % of cattle and 2-6 % of sheep in the United Kingdom have antibody to Q fever [3][4][5].

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Section: Discussionsupporting

confidence: 88%

“…When the distribution according to school years was examined the association was even stronger (X2 on 4 D.F. = 22-7, P = 0.000 15). A model containing school years alone fitted the data better than one containing age.…”

Section: Demographic Associationsmentioning

confidence: 94%

An epidemiological study of an outbreak of Q fever in a secondary school

1990

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“…An outbreak in Switzerland involved over 350 persons who lived along the road where sheep travelled from mountain pastures (Dupuis, 1987). An outbreak of Q fever occurred among residents in urban Wales living near a road over which farm vehicles carrying straw, manure or dust contaminated with C. burnetii travelled (Salmon et al 1982). C. burnetii can withstand very harsh environmental conditions (Christie, 1980) probably by virtue of its ability to form spores (McCaul & Williams, 1981).…”

Section: Discussionmentioning

confidence: 99%

Truckin' pneumonia—an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens

et al. 1989

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SUMMARYWe describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats, the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to kittens 2 weeks prior to the first case of Q fever in the plant. The cat owner fed the kittens every day before coming to work as the cat would not let the kittens suckle. Serum from the cat had high antibody titres to phase I and phase II Coxiella burnetii antigens. The attack rate among the employees where the cat owner worked, 13 of 19 (68 %), was higher than that of employees elsewhere, 3 of 13 (28%) [l' < 001]. The cat owner's wife and son also developed Q fever. None of the family members of the other employees with Q fever was so affected.We conclude that this outbreak of Q fever probably resulted from exposure to the contaminated clothing of the cat owner.

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“…In conclusion, although it is now 40 years since the first human cases of Q fever were described in England [1], it remains a most unpredictable infection, as evidenced by the continued occurrence of sporadic cases and unexpected outbreaks [45,57,58]. Its predilection for immunosuppressed patients, its diverse neurological manifestions and its propensity to follow a protracted course mean that Q fever is much more than an esoteric cause of culture negative endocarditis.…”

Section: Clinical Featuresmentioning

confidence: 99%

Q fever in Plymouth, 1972–88: A review with particular reference to neurological manifestations

Reilly

Northwood

Caul³

1990

Epidemiol. Infect.

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SUMMARYBetween 1972 and 1988 we have serologically confirmed 103 Coxiella burnetii infections: 46 were acute, 5 were chronic, 52 represented past infections. Details of 61 cases are presented.Of acute cases 80 % had respiratory involvement; at least 63 % had pneumonias. The incidence (22 %) of neurological complications was of particular interest; 40% of these patients had prolonged sequelae. One acutely ill patient died of fulminating hepatitis. Patients with pre-existing pathology or immunosuppression were especially susceptible to C. burnetii.In the absence of acute sera, the complement fixation test alone provided inadequate differentiation between recent and past Q fever: phase II titres persisted at 3 80 for more than 1 year after the acute infection in 15 cases; maximum duration of persistence was 14 years. Three patients acquired high phase I titres.Only 5% of cases had chronic Q fever, but in view of the diverse sequelae observed in this series, we suggest that long-term serological and clinical followup of all cases of Q fever is fully justified.

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Q Fever in an Urban Area

Cited by 102 publications

References 4 publications

An epidemiological study of an outbreak of Q fever in a secondary school

An epidemiological study of an outbreak of Q fever in a secondary school

Truckin' pneumonia—an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens

Q fever in Plymouth, 1972–88: A review with particular reference to neurological manifestations

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