Screening forCoxiella burnetiiseroprevalence in chronic Q fever high-risk groups reveals the magnitude of the Dutch Q fever outbreak

Kampschreur, Linda M.; Hagenaars, Julia C.J.P.; Wielders, Cornelia C H; Elsman, Peter; Lestrade, P; Koning, Olivier H.J.; Oosterheert, Jan Jelrik; Renders, Nicole H. M.; Wever, Peter C.

doi:10.1017/s0950268812001203

Cited by 67 publications

(65 citation statements)

References 13 publications

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“…These figures are in line with the previously reported rate of 1 to 5% (1, 6). However, based on seroprevalence studies, estimates of the total number of C. burnetii infections in the Dutch outbreak are up to 10-fold higher than the number of reported cases (5,23). Extrapolating these data, the number of identified chronic Q fever patients in the Netherlands does not reach this rate of 1 to 5% of C. burnetii infections by far (1).…”

Section: Discussionmentioning

confidence: 99%

Chronic Q Fever in the Netherlands 5 Years after the Start of the Q Fever Epidemic: Results from the Dutch Chronic Q Fever Database

et al. 2014

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j Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and clinical characteristics, as well as mortality, of patients with proven, probable, or possible chronic Q fever in the Netherlands, were analyzed. In total, 284 chronic Q fever patients were identified, of which 151 (53.7%) had proven, 64 (22.5%) probable, and 69 (24.3%) possible chronic Q fever. Among proven and probable chronic Q fever patients, vascular infection focus (56.7%) was more prevalent than endocarditis (34.9%). An acute Q fever episode was recalled by 27.0% of the patients. The all-cause mortality rate was 19.1%, while the chronic Q fever-related mortality rate was 13.0%, with mortality rates of 9.3% among endocarditis patients and 18% among patients with a vascular focus of infection. Increasing age (P ‫؍‬ 0.004 and 0.010), proven chronic Q fever (P ‫؍‬ 0.020 and 0.002), vascular chronic Q fever (P ‫؍‬ 0.024 and 0.005), acute presentation with chronic Q fever (P ‫؍‬ 0.002 and P < 0.001), and surgical treatment of chronic Q fever (P ‫؍‬ 0.025 and P < 0.001) were significantly associated with all-cause mortality and chronic Q fever-related mortality, respectively.

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Section: Discussionmentioning

confidence: 99%

Chronic Q Fever in the Netherlands 5 Years after the Start of the Q Fever Epidemic: Results from the Dutch Chronic Q Fever Database

et al. 2014

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“…Besides chronic Q fever (ie, persistent C. burnetii infection), which occurs in 1%-5% of cases [1], a debilitating fatigue syndrome has been described [2][3][4][5][6][7][8][9][10][11]. This Q fever fatigue syndrome (QFS) persists for years in approximately 20% of cases following acute Q fever [2][3][4][5][6][9][10][11].…”

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confidence: 99%

“…QFS has major health impacts with severe fatigue, substantial disabilities, and reduced quality of life [8,11,[13][14][15]. Following the largest Q fever outbreak ever reported [1], which occurred in the Netherlands with >4000 notified patients, the need for an evidence-based treatment regimen increased. The large number of QFS patients had major economical consequences [16].…”

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confidence: 99%

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Keijmel

Delsing

Bleijenberg

et al. 2017

Clinical Infectious Diseases

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Background. Approximately 20% of patients with acute Q fever will develop chronic fatigue, referred to as Q fever fatigue syndrome (QFS). The objective of this randomized controlled clinical trial was to assess the efficacy of either long-term treatment with doxycycline or cognitive-behavioral therapy (CBT) in reducing fatigue severity in patients with QFS.Methods. Adult patients were included who met the QFS criteria according to the Dutch guideline: a new onset of severe fatigue lasting ≥6 months with significant disabilities, related to an acute Q fever infection, without other somatic or psychiatric comorbidity explaining the fatigue. Using block randomization, patients were randomized between oral study medication and CBT (2:1) for 24 weeks. Second, a double-blind randomization between doxycycline (200 mg/day, once daily) and placebo was performed in the medication group. Primary outcome was fatigue severity at end of treatment (EOT; week 26), assessed with the Checklist Individual Strength subscale Fatigue Severity.Results. Of 155 patients randomized, 154 were included in the intention-to-treat analysis (doxycycline, 52; placebo, 52; CBT, 50). At EOT, fatigue severity was similar between doxycycline (40.8 [95% confidence interval {CI}, 37.3-44.3]) and placebo (37.8 [95% CI,.2]; difference, doxycycline vs placebo, −3.0 [97.5% CI, −8.7 to 2.6]; P = .45). Fatigue severity was significantly lower after CBT (31.6 [95% CI,.1]) than after placebo (difference, CBT vs placebo, 6.2 [97.5% CI, .5-11.9]; P = .03).Conclusions. CBT is effective in reducing fatigue severity in QFS patients. Long-term treatment with doxycycline does not reduce fatigue severity in QFS patients compared to placebo.Clinical Trials Registration. NCT01318356.

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“…At the center of the epidemic (Hertogenbosch), 10.7% (84 of 785) of the persons tested in the screening program had Phase II IgG antibodies, resulting in an estimate of around 40,600 exposed persons for the entire region [58]. In Europe, outbreaks of Q fever in sheep herds occurred in the German Federal states of Baden-Württemberg [59], Bavaria [60] and Thuringia [61], as well as in France [62], Cheltenham in England [63], and Bosnia [64].…”

Section: Current Knowledge About the Pathogenmentioning

confidence: 99%

Coxiella burnetii - Pathogenic Agent of Q (Query) Fever

Dalton¹,

Dreier²,

Rink³

et al. 2013

Transfus Med Hemother

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Screening forCoxiella burnetiiseroprevalence in chronic Q fever high-risk groups reveals the magnitude of the Dutch Q fever outbreak

Cited by 67 publications

References 13 publications

Chronic Q Fever in the Netherlands 5 Years after the Start of the Q Fever Epidemic: Results from the Dutch Chronic Q Fever Database

Chronic Q Fever in the Netherlands 5 Years after the Start of the Q Fever Epidemic: Results from the Dutch Chronic Q Fever Database

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

<b><i>Coxiella burnetii</i></b> - Pathogenic Agent of Q (Query) Fever

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