Strategies for early detection of chronic <scp>Q</scp>‐fever: a systematic review

Wielders, Cornelia C. H.; Morroy, G.; Wever, Peter C.; Coutinho, Roel A.; Schneeberger, Peter M.; Hoek, Wim van der

doi:10.1111/eci.12073

Cited by 19 publications

(22 citation statements)

References 42 publications

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“…Seventeen (9.2%) patients developed a serological profile indicative of chronic Q fever, though the majority only had high IgG phase I titres (≥1∶1,024) and no risk factors for a chronic Q fever infection, indicating a possible chronic Q fever infection according to the Dutch Q fever Consensus Group [12]. Only four (2.2%) patients had a proven chronic Q fever infection which is similar to overall conversion rates reported in literature (0–5%), though comparison with data from literature is hampered by the use of different case definitions [48].…”

Section: Discussionsupporting

confidence: 68%

Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

et al. 2014

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BackgroundFrom 2007 to 2009, the Netherlands experienced a major Q fever epidemic, with higher hospitalization rates than the 2–5% reported in the literature for acute Q fever pneumonia and hepatitis. We describe epidemiological and clinical features of hospitalized acute Q fever patients and compared patients presenting with Q fever pneumonia with patients admitted for other forms of community-acquired pneumonia (CAP). We also examined whether proximity to infected ruminant farms was a risk factor for hospitalization.MethodsA retrospective cohort study was conducted for all patients diagnosed and hospitalized with acute Q fever between 2007 and 2009 in one general hospital situated in the high incidence area in the south of the Netherlands. Pneumonia severity scores (PSI and CURB-65) of acute Q fever pneumonia patients (defined as infiltrate on a chest x-ray) were compared with data from CAP patients. Hepatitis was defined as a >twofold the reference value for alanine aminotransferase and for bilirubin.ResultsAmong the 183 hospitalized acute Q fever patients, 86.0% had pneumonia. Elevated liver enzymes (alanine aminotransferase) were found in 32.3% of patients, although hepatitis was not observed in any of them. The most frequent clinical signs upon presentation were fever, cough and dyspnoea. The median duration of admission was five days. Acute Q fever pneumonia patients were younger, had less co-morbidity, and lower PSI and CURB-65 scores than other CAP patients. Anecdotal information from attending physicians suggests that some patients were admitted because of severe subjective dyspnoea, which was not included in the scoring systems. Proximity to an infected ruminant farm was not associated with hospitalization.ConclusionHospitalized Dutch acute Q fever patients mostly presented with fever and pneumonia. Patients with acute Q fever pneumonia were hospitalized despite low PSI and CURB-65 scores, presumably because subjective dyspnoea was not included in the scoring systems.

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Section: Discussionsupporting

confidence: 68%

Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

et al. 2014

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“…Because chronic Q-fever is not classified as a notifiable disease, precise numbers are not available; however, up to May 2012, 284 patients were voluntarily registered into a database as part of a research project run by the University Medical Center Utrecht [ 7 ]. For early detection of chronic Q-fever, patients should have at least one serological examination within one year following the acute infection [ 8 ]. The serological follow-up screening of acute Q-fever patients varies widely among regions, ranging from 25% to 95% [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak

et al. 2015

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IntroductionFrom 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications. The most serious complication of Q-fever is chronic Q-fever.MethodIn 2014, we contacted all 2,161 adult inhabitants of the first village in the Netherlands affected by the Q-fever epidemic and offered to test for antibodies against Coxiella burnetii using immunofluorescence assay (IFA) to screen for chronic infections and assess whether large-scale population screening elsewhere is warranted.ResultsOf the 1,517 participants, 33.8% were IFA-positive. Six IFA-positive participants had an IgG phase I titer ≥1:512. Two of these six participants were previously diagnosed with chronic Q-fever. Chronic infection was diagnosed in one of the other four participants after clinical examination.ConclusionsSeven years after the initial outbreak, seroprevalence remains high, but the yield of screening the general population for chronic Q-fever is low. A policy of screening known high-risk groups for chronic Q-fever in outbreak areas directly following an outbreak might be more efficient than population screening. A cost-effectiveness analysis should also be performed before initiating a population screening program for chronic Q-fever.

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“…Det var da ikke indikasjon for antibakteriell behandling. Det er likevel viktig å følge opp pasienten, ettersom endokarditt kan forekomme også hos pasienter uten risikofaktorer (24). Den videre oppfølgingen vil vaere kontroll av serologiske prøver etter seks måneder og, dersom det er tegn til kronisk sykdom, utredning med ekkokardiografi.…”

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En mann i 30-årene med feber etter safari i Sør-Afrika

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Strategies for early detection of chronic Q‐fever: a systematic review

Cited by 19 publications

References 42 publications

Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak

En mann i 30-årene med feber etter safari i Sør-Afrika

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