Q Fever Update, Maritime Canada

Abstract

Since the 1990s, reports of Q fever in Nova Scotia, Canada, have declined. Passive surveillance for Q fever in Nova Scotia and its neighboring provinces in eastern Canada indicates that the clinical manifestation of Q fever in the Maritime provinces is pneumonia and that incidence of the disease may fluctuate.

The Biological Survey of Canada: A Personal History

“…The largest numbers of cases were reported from Ontario and the Maritime provinces, principally Nova Scotia, which reported 301 and 103 cases, respectively. However, since the 1990s, reports of Q fever in Nova Scotia have declined to approximately 4-5 reported cases annually (Marrie et al 2008). The largest number of cases now appear to occur in the province of Québec, consistent with the large number of sheep herds in this area of Canada (Dolce et al 2003).…”

Legionnaires' Disease: Clinical Differentiation from Typical and Other Atypical Pneumonias

“…Mimics of legionnaires' disease may be diagnosed by ordering specific acute/convalescent serology appropriate to the pathogens that are clinically relevant in the differential diagnosis. 35,53,56 Mycoplasma pneumoniae CAP Clinically, legionnaires' disease and M pneumoniae CAP are the commonest nonzoonotic atypical CAP pathogens. Atypical CAP pathogens may be clinically differentiated from typical CAP pathogens by the presence or absence of extrapulmonary clinical and laboratory findings.…”

“…Round or nodular infiltrates are not usually present in legionnaires' disease but may be present with Legionella micdadei CAP. 35,[53][54][55]69 Doxycycline is equally effective in treating legionnaires' disease and Q fever. If a loading regimen of doxycycline is not used (ie, 200 mg intravenously [IV]/by mouth [PO] every 12 h  3 days, followed by 100 mg IV/PO every 12 h), then a therapeutic response may not be evident for 4-5 days.…”

“…Q fever may be diagnosed or ruled out by acute/convalescent phase I phase II Q fever titers. 28,35,[53][54][55]59 Adenovirus CAP Adenoviral CAP may be confused with legionnaires' disease radiographically. Although there is no pathognomonic radiographic presentation of legionnaires' disease, the radiographic behavior of the infiltrates is characteristic.…”

Serologic detection of a rare case of Q fever in New York City having hepatic and unusual renal complications

“…It is, however, uncommon or infrequently reported throughout most of North America, including the United States [13], although intermittent outbreaks have occurred [10] in certain parts of Canada, especially within the eastern Maritime provinces for about the last 15-20 years. The reported prevalences, however, are highly dependant upon local interest of the medical community to this specific disease (especially the presence of a reference center for Q fever).…”