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Q Fever

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21. Should acute Q-fever patients be screened for valvulopathy to prevent endocarditis? (Full text)

Should acute Q-fever patients be screened for valvulopathy to prevent endocarditis? Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy is considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was discontinued, raising controversy in the international literature. We followed a cohort of acute Q-fever patients (...) to estimate the risk for developing chronic Q-fever, and we evaluated the impact of screening in patients who were not yet known to have a valvulopathy.The study population consisted of patients diagnosed with acute Q-fever in 2007 and 2008. We retrospectively reviewed all screening echocardiographs and checked for development of chronic Q-fever 8 years after the acute episode. Risks of developing chronic Q-fever in relation to the presence or absence of valvulopathy were analyzed with logistic

2018 Clinical Infectious Diseases PubMed

22. The effect of measuring serum doxycycline concentrations on clinical outcomes during treatment of chronic Q fever. (PubMed)

The effect of measuring serum doxycycline concentrations on clinical outcomes during treatment of chronic Q fever. First choice treatment for chronic Q fever is doxycycline plus hydroxychloroquine. Serum doxycycline concentration (SDC) >5 μg/mL has been associated with a favourable serological response, but the effect on clinical outcomes is unknown.To assess the effect of measuring SDC during treatment of chronic Q fever on clinical outcomes.We performed a retrospective cohort study, to assess (...) the effect of measuring SDC on clinical outcomes in patients treated with doxycycline and hydroxychloroquine for chronic Q fever. Primary outcome was the first disease-related event (new complication or chronic Q fever-related mortality); secondary outcomes were all-cause mortality and PCR-positivity. Multivariable analysis was performed with a Cox proportional hazards model, with shared-frailty terms for different hospitals included.We included 201 patients (mean age 68 years, 83% male): in 167 patients

2018 Journal of Antimicrobial Chemotherapy

23. Q Fever in Military Firefighters during Cadet Training in Brazil. (Full text)

Q Fever in Military Firefighters during Cadet Training in Brazil. We report five cases of Q fever among cadets during a training program for Military Firefighters Academy in the state of Rio de Janeiro, Brazil. This cluster confirms the significance of Coxiella burnetii as an infectious agent in Brazil, where the occurrence of this zoonosis is poorly documented and highlights the potential risk for Q fever transmission in rural areas or farms with infected animals.

2018 American Journal of Tropical Medicine & Hygiene PubMed

24. Familiarity of general practitioners with Q fever decreases hospitalisation risk. (PubMed)

Familiarity of general practitioners with Q fever decreases hospitalisation risk. Between 2007 and 2010, the Netherlands experienced large outbreaks of Q fever with over 4000 cases. There were unexplained geographical differences in hospitalisation rates of notified patients. We examined the extent of this geographic variation in Q fever hospitalisation and its potential association with general practitioner (GP) experience with Q fever.We included Q fever cases notified by GPs in 2008 and 2009 (...) in the affected public health region. We used linear regression to describe trends of hospitalisation over time and tested for statistical differences in hospitalisation between municipalities with the chi-square test. We used the number of previously diagnosed Q fever cases of an individual GP as a proxy for Q fever experience, grouped into four categories of GP experience (1; 2; 3-7 and 8 or more cases). We calculated adjusted odds ratios (OR) using logistic regression, taking into account clustering

2018 Netherlands Journal of Medicine

25. Seroprevalence of <i>Coxiella burnetii</i> antibodies and chronic Q fever among post-mortal and living donors of tissues and cells from 2010 to 2015 in the Netherlands. (Full text)

Seroprevalence of Coxiella burnetii antibodies and chronic Q fever among post-mortal and living donors of tissues and cells from 2010 to 2015 in the Netherlands. BackgroundAfter a large Q fever outbreak in the Netherlands in the period from 2007 to 2010, the risk of Q fever transmission through tissue and cell transplantation from undiagnosed chronic Q fever cases became a potential issue. Aim: We aimed to evaluate the risk of Q fever transmission through tissue and cell transplantation (...) . Methods: We performed a retrospective observational cohort study among 15,133 Dutch donors of tissues and stem cells from 2010 to 2015 to assess seroprevalence of Coxiella burnetii antibodies, to identify factors associated with presence of C. burnetii antibodies, and to assess the proportion of undiagnosed chronic Q fever cases. Results: The study population consisted of 9,478 (63%) femoral head donors, 5,090 (34%) post-mortal tissue donors and 565 (4%) cord blood donors. Seroprevalence of C

2018 Euro Surveillance PubMed

26. Estimating the incubation period of acute Q fever, a systematic review.

Estimating the incubation period of acute Q fever, a systematic review. Estimates of the incubation period for Q fever vary substantially between different reviews and expert advice documents. We systematically reviewed and quality appraised the literature to provide an evidence-based estimate of the incubation period of the Q fever by the aerosolised infection route. Medline (OVIDSP) and EMBASE were searched with the search limited to human studies and English language. Eligible studies (...) included persons with symptomatic, acute Q fever, and defined exposure to Coxiella burnetti. After review of 7115 titles and abstracts, 320 records were screened at full-text level. Of these, 23 studies contained potentially useful data and were quality assessed, with eight studies (with 403 individual cases where the derivation of incubation period was possible) being of sufficient quality and providing individual-level data to produce a pooled summary. We found a median incubation period of 18 days

2018 Epidemiology and infection

27. Tache Noire in a Patient with Acute Q Fever (Full text)

Tache Noire in a Patient with Acute Q Fever To describe a rare case of acute Q fever with tache noire.A 51-year-old man experienced acute Q fever showing tache noire, generally considered a pathognomonic sign of Mediterranean spotted fever (MSF) and MSF-like illness, but not a clinical feature of Q fever. The patient was treated with doxycycline 100 mg every 12 h.In the Mediterranean area, tache noire should be considered pathognomonic of MSF but it should not rule out Q fever. Clinical

2018 Medical Principles and Practice PubMed

28. Farming, Q fever and public health: agricultural practices and beyond (Full text)

Farming, Q fever and public health: agricultural practices and beyond Since the Neolithic period, humans have domesticated herbivores to have food readily at hand. The cohabitation with animals brought various advantages that drastically changed the human lifestyle but simultaneously led to the emergence of new epidemics. The majority of human pathogens known so far are zoonotic diseases and the development of both agricultural practices and human activities have provided new dynamics (...) for transmission. This article provides a general overview of some factors that influence the epidemic potential of a zoonotic disease, Q fever. As an example of a disease where the interaction between the environment, animal (domestic or wildlife) and human populations determines the likelihood of the epidemic potential, the management of infection due to the Q fever agent, Coxiella burnetii, provides an interesting model for the application of the holistic One Health approach.

2018 Archives of Public Health PubMed

29. Serosurveillance of Coxiellosis (Q-fever) and Brucellosis in goats in selected provinces of Lao People’s Democratic Republic (Full text)

Serosurveillance of Coxiellosis (Q-fever) and Brucellosis in goats in selected provinces of Lao People’s Democratic Republic Goat raising is a growing industry in Lao People's Democratic Republic, with minimal disease investigation to date, especially zoonoses. This study determined the proportional seropositivity of two zoonotic diseases: Q fever (causative agent Coxiella burnetii) and Brucellosis (Brucella species) in goats across five provinces (Vientiane Capital, Xayaboury, Xiengkhuang (...) and economic losses caused by Q fever and Brucellosis.

2018 PLoS neglected tropical diseases PubMed

30. Draft Genome Sequence of Coxiella burnetii Historical Strain Leningrad-2, Isolated from Blood of a Patient with Acute Q Fever in Saint Petersburg, Russia (Full text)

Draft Genome Sequence of Coxiella burnetii Historical Strain Leningrad-2, Isolated from Blood of a Patient with Acute Q Fever in Saint Petersburg, Russia This is the announcement of a draft genome sequence of Coxiella burnetii strain Leningrad-2, phase I. The strain, which is mildly virulent in infected guinea pigs, was isolated in 1957 from the blood of a patient with acute Q fever in Leningrad (now Saint Petersburg), Russia.Copyright © 2018 Freylikhman et al.

2018 Genome Announcements PubMed

31. Rickettsial Infections and Q Fever Amongst Febrile Patients in Bhutan (Full text)

Rickettsial Infections and Q Fever Amongst Febrile Patients in Bhutan There is limited evidence of rickettsial diseases in Bhutan. We explored the contribution of rickettsioses as a cause of undifferentiated febrile illness in patients presenting to 14 Bhutanese hospitals from October 2014 to June 2015. Obvious causes of fever were excluded clinically. Clinico-demographic information and acute blood samples were collected. Samples were tested by immunofluorescence assay (IFA) and qPCR against (...) scrub typhus group (STG), spotted fever group (SFG) and typhus group (TG) rickettsiae, and Q fever (QF). Of the 1044 patients, 539 (51.6%) were female and the mean age was 31.5 years. At least 159 (15.2%) of the patients had evidence of a concurrent rickettsial infection. Of these, 70 (6.7%), 46 (4.4%), 4 (0.4%), and 29 (2.8%) were diagnosed as acute infections with STG, SFG, TG, and QF respectively. Ten (1.0%) patients were seropositive for both SFG and TG. Seven of the 70 STG patients were

2018 Tropical Medicine and Infectious Disease PubMed

32. Interferon-γ and CXCL10 responses related to complaints in patients with Q fever fatigue syndrome (Full text)

Interferon-γ and CXCL10 responses related to complaints in patients with Q fever fatigue syndrome Approximately 20% of patients with acute Q fever develop Q fever fatigue syndrome (QFS), a debilitating fatigue syndrome. This study further investigates the role of C. burnetii-specific IFNγ, but also IL-2, CXCL9, CXCL10, and CXLC11 production in QFS patients. C. burnetii-specific IFNy, IL-2, CXCL9, CXCL10, and CXCL11 production were tested in ex vivo stimulated whole blood of QFS patients who (...) recovered from their complaints (n = 8), QFS patients with persisting complaints (n = 27), and asymptomatic Q fever seropositive controls (n = 10). With the exclusion of one outlier, stimulation with C. burnetii revealed significantly higher IFNy and CXCL10 production in QFS patients with persisting complaints (medians 288.0 and 176.0 pg/mL, respectively) than in QFS patients who recovered from their complaints (medians 93.0 and 85.5 pg/mL, respectively) (p = 0.041 and 0.045, respectively

2018 European Journal of Clinical Microbiology & Infectious Diseases PubMed

33. Trends in Q fever serologic testing by immunofluorescence from four large reference laboratories in the United States, 2012–2016 (Full text)

Trends in Q fever serologic testing by immunofluorescence from four large reference laboratories in the United States, 2012–2016 Laboratory testing for Q fever (Coxiella burnetii) is essential for a differential diagnosis, yet little is known about Q fever diagnostic testing practices in the United States. We retrospectively analyzed Q fever immunoglobulin G (IgG) indirect immunofluorescence assay (IFA) testing data between 1/1/2012-10/31/2016 from ARUP, LabCorp, Mayo Medical Laboratories (...) , and Quest Diagnostics. Data included IgG phase I and phase II titers, patient age and sex, and state and date of specimen collection. On average, 12,821 specimens were tested for Q fever annually by the participating laboratories. Of 64,106 total specimens, 84.1% tested negative for C. burnetii-specific antibodies. Positive titers ranged from 16 to 262,144 against both phase I and phase II antigens. Submission of specimens peaked during the summer months, and more specimens were submitted from the West

2018 Scientific reports PubMed

34. Q fever in Spain: Description of a new series, and systematic review (Full text)

Q fever in Spain: Description of a new series, and systematic review Forms of presentation of Q fever vary widely across Spain, with differences between the north and south. In the absence of reported case series from Galicia (north-west Spain), this study sought to describe a Q-fever case series in this region for the first time, and conduct a systematic review to analyse all available data on the disease in Spain.Patients with positive serum antibodies to Coxiella burnetii from a single (...) institution over a 5-year period (January 2011-December 2015) were included. Patients with phase II titres above 1/128 (or documented seroconversion) and compatible clinical criterial were considered as having Q fever. Patients with clinical suspicion of chronic Q-fever and IgG antibodies to phase I-antigen of over 1/1024, or persistently high levels six months after treatment were considered to be cases of probable chronic Q-fever. Systematic review: We conducted a search of the Pubmed/Medline database

2018 PLoS neglected tropical diseases PubMed

35. Autoimmunity and B-cell dyscrasia in acute and chronic Q fever: A review of the literature. (PubMed)

Autoimmunity and B-cell dyscrasia in acute and chronic Q fever: A review of the literature. Q fever infection can lead to chronic Q fever, a potentially lethal disease occurring in 1-5% of patients infected with Coxiella burnetii, characterized by the persistence of this intracellular bacterium. It usually presents as endocarditis, infected vascular aneurysms, or infected vascular prostheses. This systematic review of the literature discusses the various autoimmune syndromes and B-cell (...) dyscrasias in acute and chronic Q fever patients, that may interfere with or impede recognition and diagnosis of Q fever. Reportedly, high concentrations of anti-cardiolipin antibodies may be found in acute Q fever patients, while specifically cardiac muscle antibodies have been reported during chronic Q fever. Systemic lupus erythematosus and antiphospholipid syndrome are the most frequently reported autoimmune syndromes, followed by neuromuscular disorders and vasculitis. B-cell dyscrasia, mostly

2018 European journal of internal medicine

36. Primary and secondary arterial fistulas during chronic Q fever. (PubMed)

Primary and secondary arterial fistulas during chronic Q fever. After primary infection with Coxiella burnetii, patients may develop acute Q fever, which is a relatively mild disease. A small proportion of patients (1%-5%) develop chronic Q fever, which is accompanied by high mortality and can be manifested as infected arterial or aortic aneurysms or infected vascular prostheses. The disease can be complicated by arterial fistulas, which are often fatal if they are left untreated. We aimed (...) to assess the cumulative incidence of arterial fistulas and mortality in patients with proven chronic Q fever.In a retrospective, observational study, the cumulative incidence of arterial fistulas (aortoenteric, aortobronchial, aortovenous, or arteriocutaneous) in patients with proven chronic Q fever (according to the Dutch Chronic Q Fever Consensus Group criteria) was assessed. Proven chronic Q fever with a vascular focus of infection was defined as a confirmed mycotic aneurysm or infected prosthesis

2018 Journal of Vascular Surgery

37. Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence. (Full text)

Airborne geographical dispersal of Q fever from livestock holdings to human communities: a systematic review and critical appraisal of evidence. Q fever is a zoonotic disease caused by Coxiella burnetii. This bacterium survives harsh conditions and attaches to dust, suggesting environmental dispersal is a risk factor for outbreaks. Spatial epidemiology studies collating evidence on Q fever geographical contamination gradients are needed, as human cases without occupational exposure (...) are increasing worldwide.We used a systematic literature search to assess the role of distance from ruminant holdings as a risk factor for human Q fever outbreaks. We also collated evidence for other putative drivers of C. burnetii geographical dispersal.In all documented outbreaks, infective sheep or goats, not cattle, was the likely source. Evidence suggests a prominent role of airborne dispersal; Coxiella burnetii travels up to 18 km on gale force winds. In rural areas, highest infection risk occurs

2018 BMC Infectious Diseases PubMed

38. Chronic Q fever-related complications and mortality: data from a nationwide cohort. (PubMed)

Chronic Q fever-related complications and mortality: data from a nationwide cohort. Chronic infection with Coxiella burnetii (chronic Q fever) can cause life-threatening conditions such as endocarditis, infected vascular prostheses, and infected arterial aneurysms. We aimed to assess prognosis of chronic Q fever patients in terms of complications and mortality.A large cohort of chronic Q fever patients was assessed to describe complications, overall mortality and chronic Q fever-related (...) mortality. Chronic Q fever-related mortality was expressed as a case fatality rate (number of chronic Q fever-related deaths/number of chronic Q fever patients).Complications occurred in 166 of 439 (38%) chronic Q fever patients: in 61% of proven (153/249), 15% of probable (11/74), and 2% of possible chronic Q fever patients (2/116). Most frequently observed complications were acute aneurysms (14%), heart failure (13%), and non-cardiac abscesses (10%). Overall mortality was 38% (94/249) for proven

2018 Clinical Microbiology and Infection

39. Knowledge, Attitudes and Practices Towards Spotted Fever Group Rickettsioses and Q Fever in Laikipia and Maasai Mara, Kenya (Full text)

Knowledge, Attitudes and Practices Towards Spotted Fever Group Rickettsioses and Q Fever in Laikipia and Maasai Mara, Kenya Many factors contribute to misdiagnosis and underreporting of infectious zoonotic diseases in most sub-Saharan Africa including limited diagnostic capacity and poor knowledge. We assessed the knowledge, practices and attitudes towards spotted fever group rickettsioses (SFGR) and Q fever amongst local residents in Laikipia and Maasai Mara in Kenya. A semi-structured (...) questionnaire was administered to a total of 101 respondents including 51 pastoralists, 17 human health providers, 28 wildlife sector personnel and 5 veterinarians. The pastoralists expressed no knowledge about SFGR and Q fever. About 26.7% of the wildlife sector personnel in Laikipia expressed some knowledge about SFGR and none in Maasai Mara. None of these respondents had knowledge about Q fever. About 45.5 and 33.3% of the health providers in Laikipia and Maasai Mara respectively expressed knowledge

2016 Journal of public health in Africa PubMed

40. Epidemiology of Brucellosis, Q Fever and Rift Valley Fever at the Human and Livestock Interface in Northern Côte d'Ivoire. (PubMed)

Epidemiology of Brucellosis, Q Fever and Rift Valley Fever at the Human and Livestock Interface in Northern Côte d'Ivoire. Northern Côte d'Ivoire is the main livestock breeding zone and has the highest livestock cross-border movements in Côte d'Ivoire. The aim of this study was to provide updated epidemiological data on three neglected zoonotic diseases, namely brucellosis, Q Fever and Rift Valley Fever (RVF). We conducted three-stage cross-sectional cluster surveys in livestock and humans (...) of Brucella spp. in cattle adjusted for clustering was 4.6%. Cattle aged 5-8 years had higher odds of seropositivity (OR=3.5) than those aged ≤4years. The seropositivity in cattle was associated with having joint hygromas (OR=9), sharing the pastures with small ruminants (OR=5.8) and contact with pastoralist herds (OR=11.3). The seroprevalence of Q Fever was 13.9% in cattle, 9.4% in sheep and 12.4% in goats. The seroprevalence of RVF was 3.9% in cattle, 2.4% in sheep and 0% in goats. Seropositive ewes had

2016 Acta Tropica

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