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Q Fever

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2. Acute Q fever endocarditis: a paradigm shift following the systematic use of transthoracic echocardiography during acute Q fever. (PubMed)

Acute Q fever endocarditis: a paradigm shift following the systematic use of transthoracic echocardiography during acute Q fever. As Q fever, caused by Coxiella burnetii, is a major health challenge due to its cardiovascular complications, we aim to detect acute Q fever valvular injury to improve therapeutic management.In the French national reference center for Q fever, we prospectively collected data from patients with acute Q fever and valvular injury. We identified a new clinical entity (...) , acute Q fever endocarditis, defined as valvular lesion potentially caused by C. burnetii: vegetation, valvular nodular thickening, rupture of chorda tendinae and valve or chorda tendinae thickness. In order to determine whether or not the disease was superimposed on an underlying valvulopathy, patients' physicians were contacted. Aortic bicuspidy, valvular stenosis and insufficiency were considered as underlying valvulopathies.Of the 2,434 patients treated in our center, 1,797 had acute Q fever

2019 Clinical Infectious Diseases

3. Seroprevalence of Q fever among high-risk occupations in the Ilam province, the west of Iran. (PubMed)

Seroprevalence of Q fever among high-risk occupations in the Ilam province, the west of Iran. Q fever is a zoonotic disease of great public health importance in Iran. This disease is presented with high phase I antibody development in chronic and high phase II antibody in the acute form of illness. This study was conducted to evaluate the seroprevalence of Q fever among high-risk occupations in the Ilam province in Western Iran.In this cross-sectional study, 367 sera samples were collected from (...) of Q fever infection. Animal husbandry workers (45.13%) were at higher risk of contracting Q fever compared with other occupations in the study (17.11%).High seroprevalence of C. burnetii among high-risk occupations is a serious challenge in the Ilam province. In addition, the high seroprevalence of endemic Q fever in rural and nomadic areas and a higher concentration of occupations who are directly engaged with livestock demonstrate the critical need for preventive medicine education and training

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2019 PLoS ONE

4. Cross-sectional study of brucellosis and Q fever in Thailand among livestock in two districts at the Thai-Cambodian border, Sa Kaeo province (PubMed)

Cross-sectional study of brucellosis and Q fever in Thailand among livestock in two districts at the Thai-Cambodian border, Sa Kaeo province Brucellosis and Q fever impart high morbidity in humans and economic losses among livestock worldwide. However their prevalence is still not fully known in Thailand. We conducted a sero-survey of brucellosis and Q fever in beef, dairy cattle, goat, and sheep herds from Thai communities at the border with Cambodia, a cross-border trading center. Serum (...) samples were tested for brucellosis and Q fever by antibody-based tests at the National Institute of Animal Health, Thailand. We surveyed a total of 520 individuals from 143 herds. Brucellosis herd-level seroprevalence for beef cattle and small ruminants (goats and sheep) was 2.6% (3/117) and 13.3% (2/15) respectively. Q fever herd-level seroprevalence for beef cattle, dairy cattle, and small ruminants was 4.3% (5/117), 27.3% (3/11) and 33.3% (5/15) respectively. This study identified a significant

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2018 One health

5. A transcriptional signature associated with non-Hodgkin lymphoma in the blood of patients with Q fever. (PubMed)

A transcriptional signature associated with non-Hodgkin lymphoma in the blood of patients with Q fever. Coxiella burnetii, the agent causing Q fever, has been associated with B-cell non-Hodgkin lymphoma (NHL). To better clarify this link, we analysed the genetic transcriptomic profile of peripheral blood leukocytes from patients with C. burnetii infection to identify possible links to lymphoma. Microarray analyses revealed that 1189 genes were expressed differently (p <.001 and fold change ≥4 (...) ) in whole blood of patients with C. burnetii infection compared to controls. In addition, 95 genes expressed in patients with non-Hodgkin lymphoma (NHL) and in patients with C. burnetii persistent infection have allowed us to establish the 'C. burnetii-associated NHL signature'. Among these, 33 genes previously found modulated in C. burnetii-associated -NHL by the microarray analysis were selected and their mRNA expression levels were measured in distinct C. burnetii-induced pathologies, namely, acute Q

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2019 PLoS ONE

6. Domestic sheep show average Coxiella burnetii seropositivity generations after a sheep-associated human Q fever outbreak and lack detectable shedding by placental, vaginal, and fecal routes. (PubMed)

Domestic sheep show average Coxiella burnetii seropositivity generations after a sheep-associated human Q fever outbreak and lack detectable shedding by placental, vaginal, and fecal routes. Coxiella burnetii is a globally distributed zoonotic bacterial pathogen that causes abortions in ruminant livestock. In humans, an influenza-like illness results with the potential for hospitalization, chronic infection, abortion, and fatal endocarditis. Ruminant livestock, particularly small ruminants (...) , are hypothesized to be the primary transmission source to humans. A recent Netherlands outbreak from 2007-2010 traced to dairy goats resulted in over 4,100 human cases with estimated costs of more than 300 million euros. Smaller human Q fever outbreaks of small ruminant origin have occurred in the United States, and characterizing shedding is important to understand the risk of future outbreaks. In this study, we assessed bacterial shedding and seroprevalence in 100 sheep from an Idaho location associated

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2017 PLoS ONE

7. Q fever in an endemic region of North Queensland, Australia: A 10 year review (PubMed)

Q fever in an endemic region of North Queensland, Australia: A 10 year review Q fever is a zoonotic infection caused by Coxiella burnetii. Endemic Q fever has long been recognised in north Queensland, with north Queensland previously acknowledged to have the highest rate of notification in Australia. In this retrospective study, we reviewed the demographics and exposure of patients diagnosed with Q fever in an endemic region of north Queensland, to identify trends and exposure factors (...) for the acquisition of Q fever.A retrospective study looking at patients in the region that had tested positive for Q fever by case ascertainment between 2004 and 2014. This involved both a chart review and the completion of a patient questionnaire targeting demographics, clinical presentation, risk factors and outcomes.There were 101 patients with a positive Q fever serology and/or PCR that were identified in the region of north Queensland that was studied, between 2004 and 2014. The cohort was residents

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2017 One health

8. Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance. (PubMed)

Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance. Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake (...) by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31-38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge

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2018 PLoS ONE

9. Standardized guinea pig model for Q fever vaccine reactogenicity. (PubMed)

Standardized guinea pig model for Q fever vaccine reactogenicity. Historically, vaccination with Coxiella burnetii whole cell vaccines has induced hypersensitivity reactions in humans and animals that have had prior exposure to the pathogen as a result of infection or vaccination. Intradermal skin testing is routinely used to evaluate exposure in humans, and guinea pig hypersensitivity models have been developed to characterize the potential for reactogenicity in vaccine candidates. Here we

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2018 PLoS ONE

10. Cytokine profiles in patients with Q fever fatigue syndrome. (PubMed)

Cytokine profiles in patients with Q fever fatigue syndrome. Q fever fatigue syndrome (QFS) is a state of prolonged fatigue following around 20% of acute Q fever cases. It is thought that chronic inflammation plays a role in its etiology. To test this hypothesis we measured circulating cytokines and the ex-vivo cytokine production in patients with QFS and compared with various control groups.Peripheral blood mononuclear cells (PBMCs), whole blood, and serum were collected from 20 QFS patients (...) , 19 chronic fatigue syndrome (CFS) patients, 19 Q fever seropositive controls, and 25 age- and sex-matched healthy controls. Coxiella-specific ex-vivo production of tumor necrosis factor (TNF)α, interleukin (IL)-1β, IL-6, and interferon (IFN) was measured, together with a total of 92 circulating inflammatory proteins.PBMCs of QFS patients produced more IL-6 (P = 0.0001), TNFα (P = 0.0002), and IL-1β (P = 0.0005) than the various control groups when stimulated with Coxiella antigen. QFS patients

2019 Journal of Infection

11. Q Fever in Southern California, a Case Series of 20 Patients from a VA Medical Center. (PubMed)

Q Fever in Southern California, a Case Series of 20 Patients from a VA Medical Center. Query fever (Q fever), caused by Coxiella burnetii, was first described in southern California in 1947. It was found to be endemic and enzoonotic to the region and associated with exposure to livestock. We describe a series of 20 patients diagnosed with Q fever at a Veterans Affairs hospital in southern California, with the aim of contributing toward the understanding of Q fever in this region. Demographics (...) , laboratory data, diagnostic imaging, risk factors, and treatment regimens were collected via a retrospective chart review of patients diagnosed with Q fever at our institution between 2000 and 2016. Cases were categorized as acute or chronic and confirmed or probable. The majority presented with an acute febrile illness (90%). There was a delay in ordering diagnostic serology from the time of symptom onset (acute cases, average 31.9 days; chronic cases, average 63 days), and 15% progressed from acute

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2019 American Journal of Tropical Medicine & Hygiene

12. Long-term effect of cognitive behavioural therapy and doxycycline treatment for patients with Q fever fatigue syndrome: One-year follow-up of the Qure study. (PubMed)

Long-term effect of cognitive behavioural therapy and doxycycline treatment for patients with Q fever fatigue syndrome: One-year follow-up of the Qure study. Previously, we reported a randomized placebo-controlled trial, the Qure study, showing that cognitive behavioural therapy (CBT), and not doxycycline, was significantly more effective than placebo in reducing fatigue severity in Q fever fatigue syndrome (QFS) patients. This follow-up study evaluates the long-term effect of these treatment

2019 Journal of psychosomatic research Controlled trial quality: predicted high

13. Re: 'Chronic Q fever-related complications and mortality: data from a nationwide cohort' by Roeden et al. (PubMed)

Re: 'Chronic Q fever-related complications and mortality: data from a nationwide cohort' by Roeden et al. The mortality rate reported from the Netherlands was 3.3 times higher than that observed from the French National Reference Center for Q fever. In the French National reference center for Q fever, we propose the early detection of factors that promote complications (anticardiolipins and underlying valvulopathy with transthoracic cardiac echocardiography), the early detection of persistent C

2019 Clinical Microbiology and Infection

14. The sexual dimorphism of anticardiolipin autoantibodies in acute Q fever patients. (PubMed)

The sexual dimorphism of anticardiolipin autoantibodies in acute Q fever patients. Q fever is a zoonotic disease caused by Coxiella burnetii which affects men more than women (sex ratio men/women: 2.2). Acute Q fever complications are associated with elevation of anticardiolipin (aCL) antibodies. Here, we investigate the sexual dimorphism of aCL antibodies during acute C. burnetii infection.IgG aCL antibodies were evaluated at the time of Q fever serological diagnosis with enzyme-linked (...) immunosorbent assay. Results were analysed according to sex.Among the 1323 patients with Q fever tested for aCL, 1013 had acute Q fever (692 men/321 women) and 310 had persistent focalized infection (226 men/84 women). In cases of acute Q fever, men presented a significantly higher proportion of positive aCL antibodies (351/692, 50.7%) than women (113/321, 35.2%) (p <0.05). In addition, men had significantly higher aCL antibodies levels than women (p <0.001).We highlight a relationship between sex

2019 Clinical Microbiology and Infection

15. Seroprevalence of Q fever among metropolitan and non-metropolitan blood donors in New South Wales and Queensland, 2014-2015. (PubMed)

Seroprevalence of Q fever among metropolitan and non-metropolitan blood donors in New South Wales and Queensland, 2014-2015. To estimate the prevalence of exposure to the causative agent of Q fever (Coxiella burnetii) and of current infections among blood donors in Australia.Cross-sectional study in metropolitan Sydney and Brisbane, and in non-metropolitan regions with high Q fever notification rates (Hunter New England in New South Wales; Toowoomba in Queensland).Blood donors attending Red (...) Cross collection centres during October 2014 - June 2015 who provided sera and completed a questionnaire on Q fever vaccination status, diagnosis and knowledge, and exposure history.Age- and sex-standardised seroprevalence of phase II IgG antibodies to C. burnetii (indicating past exposure) and independent risk factors for seropositivity; presence of C. burnetii DNA (indicating current infection and risk of transmission by blood transfusion).2740 donors (94.5% response rate) completed

2019 Medical Journal of Australia

16. Current perspectives on the transmission of Q fever: Highlighting the need for a systematic molecular approach for a neglected disease in Africa. (PubMed)

Current perspectives on the transmission of Q fever: Highlighting the need for a systematic molecular approach for a neglected disease in Africa. Q fever is a bacterial worldwide zoonosis (except New Zealand) caused by the Gram-negative obligate intracellular bacterium Coxiella burnetii (C. burnetii). The bacterium has a large host range including arthropods, wildlife and companion animals and is frequently identified in human and livestock populations. In humans, the disease can occur (...) as either a clinically acute or chronic aetiology, affecting mainly the lungs and liver in the acute disease, and heart valves when chronic. In livestock, Q fever is mainly asymptomatic; however, the infection can cause abortion, and the organism is shed in large quantities, where it can infect other livestock and humans. The presence of Q fever in Africa has been known for over 60 years, however while our knowledge of the transmission routes and risk of disease have been well established in many parts

2019 Acta Tropica

17. Case Report: Scrub Typhus and Q Fever Coinfection. (PubMed)

Case Report: Scrub Typhus and Q Fever Coinfection. A 56-year-old female goat herder had scrub typhus that persisted after receiving doxycycline for 5 days. Her symptoms continued, prompting us to perform further examinations that revealed coinfection of Q fever and scrub typhus via molecular and serological testing. We also isolated Orientia tsutsugamushi using BALB/c mice and L929 cells.

2019 American Journal of Tropical Medicine & Hygiene

18. Diagnostic usefulness of molecular detection of Coxiella burnetii from blood of patients with suspected acute Q fever. (PubMed)

Diagnostic usefulness of molecular detection of Coxiella burnetii from blood of patients with suspected acute Q fever. Diagnosis of Q fever is difficult due to the lack of distinct clinical features that distinguish it from other febrile diseases. Serologic testing is the gold standard method for diagnosing Q fever, but antibody formation may not be detectable for 2 to 3 weeks from symptom onset, limiting early diagnosis. We thus evaluated the diagnostic utility of polymerase chain reaction (...) (PCR) to detect Coxellia burnetii DNA in serum from patients with suspected acute Q fever.All adult patients with suspected acute Q fever were prospectively enrolled at a tertiary-care hospital from January 2016 through July 2018. Acute Q fever was diagnosed using clinical and laboratory criteria: fever with at least one other symptoms (myalgia, headache, pneumonia, or hepatitis) and single phase II immunoglobulin G (IgG) antibody titers ≥1:200 or immunoglobulin M (IgM) antibody titer ≥1:50

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2019 Medicine

19. Chronic Q fever associated with systemic sclerosis. (PubMed)

Chronic Q fever associated with systemic sclerosis. After the Q fever outbreak in the Netherlands between 2007 and 2010, more than 300 patients with chronic Q fever have been identified. Some patients were also diagnosed with systemic sclerosis, a rare immune-mediated disease. We aimed to increase awareness of concomitant chronic Q fever infection and systemic sclerosis and to give insight into the course of systemic sclerosis during persistent Q fever infection.Chronic Q fever patients were (...) identified after the Dutch Q fever outbreak in 2007-2010. Systemic sclerosis was diagnosed by a scleroderma expert and patients fulfilled the 2013 Classification Criteria for Systemic Sclerosis.Four cases presented with chronic Q fever, persistent Coxiella burnetii infection, shortly preceded or followed by the diagnosis of limited cutaneous systemic sclerosis. The three male patients of 60 years or older developed a relatively mild systemic sclerosis, which did not require immunosuppressive therapy

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2019 European journal of clinical investigation

20. Genetic variations in innate immunity genes affect response to Coxiella burnetii and are associated with susceptibility to chronic Q fever. (PubMed)

Genetic variations in innate immunity genes affect response to Coxiella burnetii and are associated with susceptibility to chronic Q fever. Chronic Q fever is a persistent infection, mostly of aortic aneurysms, vascular prostheses or damaged heart valves, caused by the intracellular bacterium Coxiella burnetii. Only a fraction of C. burnetii-infected individuals at risk develop chronic Q fever. In these individuals, a defective innate immune response may contribute to the development of chronic (...) Q fever. We assessed whether genetic variations in genes involved in the killing machinery for C. burnetii by macrophages, contribute to the progression to chronic Q fever.The prevalence of 66 single nucleotide polymorphisms (SNPs) in 31 genes pivotal in phagolysosomal maturation, bacterial killing and autophagy, was determined in 173 chronic Q fever patients and 184 controls with risk factors for chronic Q fever and serological evidence of a C. burnetii infection. Associations were detected

2019 Clinical Microbiology and Infection

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