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Q Fever

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121. Lassa fever

that she has no competing interests. Consultant in Tropical and Travel Medicine Hospitals for Tropical Diseases Senior Lecturer London School of Hygiene and Tropical Medicine London UK Disclosures RB has provided expert testimony to the courts, on behalf of the Crown, regarding Q fever. RB has been a paid member of the Advisory Board for Takeda regarding Dengue vaccine. He has been a paid member of the Advisory Board for Valneva UK regarding Ixiaro, a vaccine for Japanese encephalitis. Peer reviewers (...) Lassa fever Lassa fever - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Lassa fever Last reviewed: February 2019 Last updated: February 2019 Summary Notifiable condition. Early recognition, isolation of the patient, and appropriate infection control measures are a critical part of management. Asymptomatic or mild febrile illness in approximately 80% of patients, which can make diagnosis difficult. Severe symptoms

2018 BMJ Best Practice

122. Neurocognitive disturbances associated with acute infectious mononucleosis, Ross River fever and Q fever: a preliminary investigation of inflammatory and genetic correlates. (PubMed)

Neurocognitive disturbances associated with acute infectious mononucleosis, Ross River fever and Q fever: a preliminary investigation of inflammatory and genetic correlates. Disturbances in neurocognitive performance are a core feature of the acute sickness response to infection; however the underlying mechanisms remain unclear. The current study used a computerised battery to assess neurocognitive functioning in subjects enrolled in the Dubbo Infection Outcomes Study (n=107) - a prospective

2014 Brain, behavior, and immunity

123. A Combination of IFN-γ and IL-2 Production by Coxiella burnetii Stimulated Circulating Cells Discriminates Between Chronic Q Fever and Past Q Fever. (Full text)

A Combination of IFN-γ and IL-2 Production by Coxiella burnetii Stimulated Circulating Cells Discriminates Between Chronic Q Fever and Past Q Fever. Infection with Coxiella burnetii may lead to life-threatening chronic Q fever endocarditis or vascular infections, which are often difficult to diagnose. The present study aims to investigate whether measurement of in-vitro interferon-gamma (IFN-γ) production, a key cytokine in the immune response against C. burnetii, differentiates chronic from (...) a past cleared infection, and whether measurement of other cytokines would improve the discriminative power. First, C. burnetii-specific IFN-γ production was measured in whole blood of 28 definite chronic Q fever patients and compared with 135 individuals with past Q fever (seropositive controls) and 908 seronegative controls. IFN-γ production was significantly higher in chronic Q fever patients than in controls, but with overlapping values between patients and seropositives. Secondly, the production

2013 Clinical Microbiology and Infection PubMed

124. Limited humoral and cellular responses to Q fever vaccination in older adults with risk factors for chronic Q fever. (PubMed)

Limited humoral and cellular responses to Q fever vaccination in older adults with risk factors for chronic Q fever. In the Netherlands, people at risk for chronic Q fever were vaccinated against Coxiella burnetii with the inactivated whole cell vaccine Q-vax®. We aimed to measure the immune responses to C. burnetii six and twelve months after vaccination in this relevant population.In 260 vaccinees, antibody responses were assessed by immunofluorescence assay (IFA), complement fixation test (...) and ELISA. The cellular immune responses were assessed by measuring C. burnetii-specific interferon (IFN)-γ production in blood. Serological results of 200 individuals with past Q fever were used for comparison.At six months, 46% of vaccinees showed low IFA antibody titres and 67% had a positive IFN-γ assay; At twelve months, both were 60%. In contrast, individuals with a past Q fever were seropositive in 99.5% at six and twelve months, with relatively higher IFA titres. Interestingly, vaccinees

2013 Journal of Infection

125. Ado-trastuzumab emtansine (T-DM1) in patients with HER2 amplified tumors excluding breast and gastric/gastro-esophageal junction (GEJ) adenocarcinomas: Results from the NCI-MATCH Trial (EAY131) Sub-protocol Q. (PubMed)

Ado-trastuzumab emtansine (T-DM1) in patients with HER2 amplified tumors excluding breast and gastric/gastro-esophageal junction (GEJ) adenocarcinomas: Results from the NCI-MATCH Trial (EAY131) Sub-protocol Q. The NCI-MATCH is a national precision medicine study incorporating centralized genomic testing to direct refractory cancer patients to molecularly targeted treatment subprotocols. This treatment subprotocol was designed to screen for potential signals of efficacy of ado-trastuzumab (...) gland and 1 parotid gland squamous cell cancer. Seventeen patients (47%) had stable disease (SD) including 8/10 (80%) with ovarian and uterine carcinomas, with median duration of 4.6 months. The 6-month progression free survival rate was 23.6% (90% CI 14.2%-39.2%). Common toxicities included fatigue, anemia, fever and thrombocytopenia with no new safety signals. There was a trend for tumor shrinkage with higher levels of gene copy number as determined by the NGS assay.T-DM1 was well tolerated. While

2019 Annals of Oncology

126. Q Fever Chronic Osteomyelitis in Two Children. (Full text)

Q Fever Chronic Osteomyelitis in Two Children. We report 2 cases of chronic Q fever osteomyelitis in 10- and 5-year-old girls who presented with distal right femoral and left parasternal granulomatous osteomyelitis, respectively. Both were treated with ciprofloxacin and rifampin with good response. Q fever osteomyelitis is a challenging diagnosis in children, and the choice of antimicrobial treatment is difficult because of limited available data.

2015 Pediatric Infectious Dsease Journal PubMed

127. Vascular complications and surgical interventions after world's largest Q fever outbreak. (PubMed)

Vascular complications and surgical interventions after world's largest Q fever outbreak. Since chronic Q fever often develops insidiously, and symptoms are not always recognized at an early stage, complications are often present at the time of diagnosis. We describe complications associated with vascular chronic Q fever as found in the largest cohort of chronic Q fever patients so far.Patients with proven or probable chronic Q fever with a focus of infection in an aortic aneurysm or vascular (...) graft were included in this study, using the Dutch national chronic Q fever database.A total of 122 patients were diagnosed with vascular chronic Q fever between April 2008 and June 2012. The infection affected a vascular graft in 62 patients (50.8%) and an aneurysm in 53 patients (43.7%). Seven patients (5.7%) had a different vascular focus. Thirty-six patients (29.5%) presented with acute complications, and 35 of these patients (97.2%) underwent surgery. Following diagnosis and start of antibiotic

2015 Journal of Vascular Surgery

128. Integrating interdisciplinary methodologies for One Health: goat farm re-implicated as the probable source of an urban Q fever outbreak, the Netherlands, 2009. (Full text)

Integrating interdisciplinary methodologies for One Health: goat farm re-implicated as the probable source of an urban Q fever outbreak, the Netherlands, 2009. In spring 2008, a goat farm experiencing Q fever abortions ("Farm A") was identified as the probable source of a human Q fever outbreak in a Dutch town. In 2009, a larger outbreak with 347 cases occurred in the town, despite no clinical Q fever being reported from any local farm.Our study aimed to identify the source of the 2009 outbreak (...) the unexplained cases (p = 0.004). A visit to Farm A revealed that there had been no particular changes in management during the spring/summer of 2009, nor any animal health problems around the time of parturition or at any other time during the year.We conclude that the probable source of the 2009 outbreak was the same farm implicated in 2008, despite animal health indicators being absent. Veterinary and public health professionals should consider farms with past as well as current history of Q fever

2015 BMC Infectious Diseases PubMed

129. Coxiellaburnetii Infectivity Lower in Children than Adults Following Community Exposure: Overlooked Cause of Infrequent Q-Fever Reporting in the Young. (PubMed)

Coxiellaburnetii Infectivity Lower in Children than Adults Following Community Exposure: Overlooked Cause of Infrequent Q-Fever Reporting in the Young. Q fever is rarely reported in children/adolescents. Although lower reporting rates are commonly attributed to milder disease and subsequent underdiagnosis in infected children/adolescents, pertinent evidence is scarce. We present data from a large, well-defined single-point source outbreak of Q fever to fill this gap.We compared (A) Q fever (...) testing and notification rates in children/adolescents who were 0-19 years of age with those in adults 20+ years of age in October 2009; (B) serological attack rates of acute Q fever in children/adolescents with the rates in adults after on-source exposure on the outbreak farm's premises; (C) incidence of Q fever infection in children/adolescents with that in adults after off-source exposure in the municipality located closest to the farm.(A) Children/adolescents represented 19.3% (59,404 of 307,348

2015 Pediatric Infectious Dsease Journal

130. Iliopsoas abscess associated with endovascular infection: an acute case of chronic Q fever. (PubMed)

Iliopsoas abscess associated with endovascular infection: an acute case of chronic Q fever. fever is a zoonosis caused by Coxiella burnetii, which occurs worldwide. After acute Q fever infection, 1% to 5% of patients develop chronic Q fever. Chronic Q fever usually presents as endocarditis or endovascular infection. The diagnosis and localization of chronic Q fever are challenging, as most patients present with nonspecific symptoms. Moreover, it often occurs in patients without a known episode

2015 American Journal of Emergency Medicine

131. Chronic Q Fever Diagnosis— Consensus Guideline versus Expert Opinion. (PubMed)

Chronic Q Fever Diagnosis— Consensus Guideline versus Expert Opinion. Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier Raoult to all 284 chronic Q fever patients included in the Dutch National Chronic Q Fever Database during 2006–2012 (...) . Of the patients who had proven cases of chronic Q fever by the Dutch guideline, 46 (30.5%)would not have received a diagnosis by the alternative criteria designed by Raoult, and 14 (4.9%) would have been considered to have possible chronic Q fever. Six patients with proven chronic Q fever died of related causes. Until results from future studies are available, by which current guidelines can be modified, we believe that the Dutch literature-based consensus guideline is more sensitive and easier to use

2015 Emerging Infectious Diseases

132. Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands(1). (Full text)

Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands(1). Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case-control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q (...) fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q

2015 Emerging Infectious Diseases PubMed

133. Risk factors and burden of acute Q fever in older adults in New South Wales: a prospective cohort study. (PubMed)

Risk factors and burden of acute Q fever in older adults in New South Wales: a prospective cohort study. To measure the acute burden of and to identify risk factors associated with notified Q fever in older adults in New South Wales.A prospective cohort of adults aged 45 years and over (the 45 and Up Study) recruited during 2006-2009 and followed using linked Q fever notifications, hospital records and death records during 2006-2012.Incident cases of Q fever, based on a linked Q fever (...) notification; proportion of cases with a Q fever-coded hospitalisation.A total of 266 906 participants were followed up for 1 254 650 person-years (mean, 4.7 ± 1.0 years per person). In our study population, the incidence of notified Q fever during follow-up was 3.6 (95% CI, 2.7-4.8) per 100 000 person-years. After adjustments, age (≥ 65 years v 45-54 years: hazard ratio [HR], 0.39; 95% CI, 0.16-0.96), sex (women v men: HR, 0.48; 95% CI, 0.26-0.88), and area and type of residence (P < 0.001 for trend

2015 Medical Journal of Australia

134. Subacute, tetracycline-responsive, granulomatous osteomyelitis in an adult man, consistent with Q fever infection (Full text)

Subacute, tetracycline-responsive, granulomatous osteomyelitis in an adult man, consistent with Q fever infection Osteomyelitis due to Coxiella burnetii infection is a rare condition in adults. We report the case of a healthy young man presenting with subacute osteomyelitis of the left cheek bone, evolving gradually after an episode of acute febrile illness. Histological evaluation confirmed subacute granulomatous inflammation. Despite antibody titres not reaching the standard cut-off (...) for chronic Q fever (phase I IgG 1/160, phase II IgG 1/2560), osteomyelitis was radiologically and histologically confirmed. A 6-month course of doxycycline/hydroxychloroquine brought clinical and radiological cure while various conventional antibiotic treatments had failed to improve the clinical condition. Currently, at 6-month follow-up, no relapse has occurred and antibody titres have declined. A shorter course of doxycycline/hydroxychloroquine than that used for chronic Q fever osteomyelitis may

2015 BMJ case reports PubMed

135. Chronic Q-Fever (Coxiella burnetii) Causing Abdominal Aortic Aneurysm and Lumbar Osteomyelitis: A Case Report (Full text)

Chronic Q-Fever (Coxiella burnetii) Causing Abdominal Aortic Aneurysm and Lumbar Osteomyelitis: A Case Report Coxiella burnetii is a rare cause of chronic infection that most frequently presents as endocarditis. We report a case of C burnetii causing an infected abdominal aortic aneurysm with contiguous lumbar osteomyelitis resulting in spinal cord compromise. The diagnosis was established by serologic studies consistent with chronic Q-fever (ratio of C burnetii immunoglobulin [Ig]G phase II

2015 Open forum infectious diseases PubMed

136. Q Fever Outbreak among Workers at a Waste-Sorting Plant (Full text)

Q Fever Outbreak among Workers at a Waste-Sorting Plant An outbreak of Q fever occurred in February-April 2014 among workers at a waste-sorting plant in Bilbao (Spain). The outbreak affected 58.5% of investigated employees, 47.2% as confirmed cases (PCR and/or serology) and 11.3% as probable cases (symptoms without laboratory confirmation). Only employees who had no-access to the waste processing areas of the plant were not affected and incidence of infection was significantly higher among

2015 PloS one PubMed

137. Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever. (Full text)

Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever. Coxiella burnetii endocarditis is considered to be a late complication of Q fever in patients with preexisting valvular heart disease (VHD). We observed a large transient aortic vegetation in a patient with acute Q fever and high levels of IgG anticardiolipin antibodies (IgG aCL). Therefore, we sought to determine how commonly acute Q fever could cause valvular vegetations associated with antiphospholipid antibody (...) syndrome, which would be a new clinical entity.We performed a consecutive case series between January 2007 and April 2014 at the French National Referral Center for Q fever. Age, sex, history of VHD, immunosuppression, and IgG aCL assessed by enzyme-linked immunosorbent assay were tested as potential predictors.Of the 759 patients with acute Q fever and available echocardiographic results, 9 (1.2%) were considered to have acute Q fever endocarditis, none of whom had a previously known VHD. After

2015 Clinical Infectious Diseases PubMed

138. Association of Human Q Fever with Animal Husbandry, Taiwan, 2004-2012. (Full text)

Association of Human Q Fever with Animal Husbandry, Taiwan, 2004-2012. In Taiwan, Q fever cases in humans began increasing in 2004 and peaked in 2007 but dramatically declined in 2008 and 2011. Cases were significantly correlated with the number of goats. The decline might be associated with the collateral effects of measures to control goat pox in 2008 and 2010.

2015 Emerging Infectious Diseases PubMed

139. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics. (Full text)

A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics. Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat (...) the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible. Copyright © 2015

2015 Pediatrics PubMed

140. Improved correlation of human Q fever incidence to modelled C. burnetii concentrations by means of an atmospheric dispersion model (Full text)

Improved correlation of human Q fever incidence to modelled C. burnetii concentrations by means of an atmospheric dispersion model Atmospheric dispersion models (ADMs) may help to assess human exposure to airborne pathogens. However, there is as yet limited quantified evidence that modelled concentrations are indeed associated to observed human incidence.We correlated human Q fever (caused by the bacterium Coxiella burnetii) incidence data in the Netherlands to modelled concentrations from

2015 International journal of health geographics PubMed

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