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Q Fever

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141. First Draft Genome Sequence of a Human Coxiella burnetii Isolate, Originating from the Largest Q Fever Outbreak Ever Reported, the Netherlands, 2007 to 2010 (Full text)

First Draft Genome Sequence of a Human Coxiella burnetii Isolate, Originating from the Largest Q Fever Outbreak Ever Reported, the Netherlands, 2007 to 2010 In 2009, Coxiella burnetii caused a large regional outbreak of Q fever in South Limburg, the Netherlands. Here, we announce the genome draft sequence of a human C. burnetii isolate, strain NL-Limburg, originating from this outbreak, including a brief summary of the genome's general features. Copyright © 2015 Hammerl et al.

2015 Genome Announcements PubMed

142. The Recent Evolution of a Maternally-Inherited Endosymbiont of Ticks Led to the Emergence of the Q Fever Pathogen, Coxiella burnetii (Full text)

The Recent Evolution of a Maternally-Inherited Endosymbiont of Ticks Led to the Emergence of the Q Fever Pathogen, Coxiella burnetii Q fever is a highly infectious disease with a worldwide distribution. Its causative agent, the intracellular bacterium Coxiella burnetii, infects a variety of vertebrate species, including humans. Its evolutionary origin remains almost entirely unknown and uncertainty persists regarding the identity and lifestyle of its ancestors. A few tick species were recently (...) found to harbor maternally-inherited Coxiella-like organisms engaged in symbiotic interactions, but their relationships to the Q fever pathogen remain unclear. Here, we extensively sampled ticks, identifying new and atypical Coxiella strains from 40 of 58 examined species, and used this data to infer the evolutionary processes leading to the emergence of C. burnetii. Phylogenetic analyses of multi-locus typing and whole-genome sequencing data revealed that Coxiella-like organisms represent

2015 PLoS pathogens PubMed

143. Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic (Full text)

Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007-2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever.A cohort of adult (...) acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever.Of the invited 1,907 patients fulfilling

2015 PloS one PubMed

144. Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak (Full text)

Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak From 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.In 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.Of 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.Seven years after the initial outbreak, seroprevalence remains high, but the yield of screening the general population for chronic Q-fever

2015 PloS one PubMed

145. Genetic variation in pattern recognition receptors and adaptor proteins associated with development of chronic Q fever. (Full text)

Genetic variation in pattern recognition receptors and adaptor proteins associated with development of chronic Q fever. Q fever is an infection caused by Coxiella burnetii. Persistent infection (chronic Q fever) develops in 1%-5% of patients. We hypothesize that inefficient recognition of C. burnetii and/or activation of host-defense in individuals carrying genetic variants in pattern recognition receptors or adaptors would result in an increased likelihood to develop chronic Q fever.Twenty (...) -four single-nucleotide polymorphisms in genes encoding Toll-like receptors, nucleotide-binding oligomerization domain-like receptor-2, αvβ3 integrin, CR3, and adaptors myeloid differentiation primary response protein 88 (MyD88), and Toll interleukin 1 receptor domain-containing adaptor protein (TIRAP) were genotyped in 139 patients with chronic Q fever and in 220 controls with cardiovascular risk-factors and previous exposure to C. burnetii. Associations between these single-nucleotide

2015 Journal of Infectious Diseases PubMed

146. Delayed Diagnosis of Q Fever: Finally Diagnosed After Elective Cardiac Surgery. (PubMed)

Delayed Diagnosis of Q Fever: Finally Diagnosed After Elective Cardiac Surgery. Q fever is a bacterial infection caused by Coxiella burnetti. It can cause both acute and chronic illness. Chronic QF can present as a variety of clinical syndromes. A common and critical manifestation is endocarditis which can present atypically and is easily missed. This case describes a man who, after extensive investigation for splenomegaly and pancytopenia by several specialties, was finally diagnosed with Q (...) fever endocarditis after unexpected aortic valve abnormalities found during elective cardiac surgery. Several factors contributed to diagnostic delay including aspects of clinical assessment and radiologic findings. Vigilance is essential for diagnosis and prompt initiation of effective treatment. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2015 Annals of Thoracic Surgery

147. Rainfall and Sloth Births in May, Q Fever in July, Cayenne, French Guiana. (Full text)

Rainfall and Sloth Births in May, Q Fever in July, Cayenne, French Guiana. Q fever in French Guiana is correlated with the rainy season. We found a 1- to 2-month lagged correlation between Q fever incidence and the number of births of three-toed sloth. This result strengthens the hypothesis that the three-toed sloth is the wild reservoir of Q fever in French Guiana.© The American Society of Tropical Medicine and Hygiene.

2015 American Journal of Tropical Medicine & Hygiene PubMed

148. Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands. (Full text)

Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands. Whether areas affected by Q fever during a large outbreak (2008-2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever.Nationwide registry-based ecological study.Pregnant women in areas affected and not affected by Q fever in the Netherlands, 2003-2004 and 2008-2010.Index group (N=58,737): pregnant women in 307 areas with more than two (...) Q fever notifications. Reference group (N=310,635): pregnant women in 921 areas without Q fever notifications. As a baseline, pregnant women in index and reference areas in the years 2003-2004 were also included in the reference group to estimate the effect of Q fever in 2008-2010, and not the already existing differences before the outbreak.Preterm delivery, small for gestational age, perinatal mortality.In 2008-2010, there was no association between residing in a Q fever-affected area and both

2015 BMJ open PubMed

149. Familial Q fever clustering with variable manifestations imitating infectious and autoimmune disease. (Full text)

Familial Q fever clustering with variable manifestations imitating infectious and autoimmune disease. Q fever, caused by Coxiella burnetii, can present as an outbreak of acute disease ranging from asymptomatic disease, pneumonia, hepatitis or fever of unknown origin, which can progress to a chronic disease, most frequently endocarditis. The occurrence of Q fever within families is rarely described, and in most cases presents with uniform acute disease manifestations. Here we present a familial (...) cluster of Q fever presenting as highly variable synchronous manifestations in four of five family members, including prolonged fever of unknown origin, asymptomatic carrier state, hepatitis, and chronic endocarditis developing in the absence of previous symptoms. This case series highlights the possibility of Q fever developing in cohabitated individuals with highly variable symptoms masking the common disease etiology. Screening of all exposed individuals, even those not clinically suspected

2015 Clinical Microbiology and Infection PubMed

150. What's new in Q fever? (PubMed)

What's new in Q fever? Q fever is a worldwide zoonotic infection with an epidemiological pattern consisting of sporadic cases, endemic situations and outbreaks of unsuspected magnitude, as occurred in Holland. This event highlighted the fact that the term "chronic Q fever" is misleading and should be avoided. Here, we review recent advances in the understanding and management of this disease. There have been clonal outbreaks of confirmed "geotypes," such as the outbreaks in French Guiana, where (...) a very high incidence was restricted to one city, with a specific clinical expression, an unusual serological response and a putative common reservoir. The advent of positron emission tomography has improved the diagnosis of endocarditis, vascular and osteoarticular infections. Molecular tests, including fluorescent in situ hybridization, may be included in the diagnostic strategy using the new criteria for endocarditis, vascular and osteoarticular infections. Q fever during pregnancy is challenging

2015 Journal of Infection

151. Q fever in China: a systematic review, 1989-2013. (PubMed)

Q fever in China: a systematic review, 1989-2013. Q fever, first described in 1937, is a worldwide zoonosis caused by Coxiella burnetii that has long been considered an under-reported and under-diagnosed illness. In China, the disease was initially reported in 1950 and in the last 25 years (1989-2013) there have been 29 reports on Q fever in China, nearly half of which were in the last 5 years. These publications have largely been in Chinese and in this review we summarize their findings (...) to enable a better understanding of Q fever in China. The overall prevalence of C. burnetii infections in the reports is 10% (1139/11 209) in people, 15% (288/1918) in cattle and 12% (176/1440) in goats. These infections occurred widely in China with positive people and/or animals reported in 64 cities/municipalities from 19 provinces, particularly those in the eastern, western and northern areas. Cattle and goats had the highest seroprevalences of all the domestic animals studied and a wide variety

2015 Epidemiology and infection

152. Assessing the long-term health impact of Q-fever in the Netherlands: a prospective cohort study started in 2007 on the largest documented Q-fever outbreak to date. (Full text)

Assessing the long-term health impact of Q-fever in the Netherlands: a prospective cohort study started in 2007 on the largest documented Q-fever outbreak to date. Between 2007 and 2011, the Netherlands experienced the largest documented Q-fever outbreak to date with a total of 4108 notified acute Q-fever patients. Previous studies have indicated that Q-fever patients may suffer from long-lasting health effects, such as fatigue and reduced quality of life. Our study aims to determine the long (...) -term health impact of Q-fever. It will also compare the health status of Q-fever patients with three reference groups: 1) healthy controls, 2) patients with Legionnaires' disease and 3) persons with a Q-fever infection but a-specific symptoms.Two groups of Q-fever patients were included in a prospective cohort study. In the first group the onset of illness was in 2007-2008 and participation was at 12 and 48 months. In the second group the onset of illness was in 2010-2011 and participation was at 6

2012 BMC Infectious Diseases PubMed

153. Histological characteristics of the abdominal aortic wall in patients with vascular chronic Q fever (Full text)

Histological characteristics of the abdominal aortic wall in patients with vascular chronic Q fever The aim of this study was to describe specific histological findings of the Coxiella burnetii-infected aneurysmal abdominal aortic wall. Tissue samples of the aneurysmal abdominal aortic wall from seven patients with chronic Q fever and 15 patients without evidence of Q fever infection were analysed and compared. Chronic Q fever was diagnosed using serology and tissue PCR analysis. Histological (...) sections were stained using haematoxylin and eosin staining, Elastica van Gieson staining and immunohistochemical staining for macrophages (CD68), T lymphocytes (CD3), T lymphocyte subsets (CD4 and CD8) and B lymphocytes (CD20). Samples were scored by one pathologist, blinded for Q fever status, using a standard score form. Seven tissue samples from patients with chronic Q fever and 15 tissue samples from patients without Q fever were collected. Four of seven chronic Q fever samples showed

2014 International journal of experimental pathology PubMed

154. Q Fever in French Guiana. (Full text)

Q Fever in French Guiana. Coxiella burnetii, the causative agent of Q fever, is present worldwide. Recent studies have shown that this bacterium is an emerging pathogen in French Guiana and has a high prevalence (24% of community-acquired pneumonia). In this review, we focus on the peculiar epidemiology of Q fever in French Guiana. We place it in the context of the epidemiology of the disease in the surrounding countries of South America. We also review the clinical features of Q fever (...) in this region, which has severe initial presentation but low mortality rates. These characteristics seem to be linked to a unique genotype (genotype 17). Finally, we discuss the issue of the animal reservoir of C. burnetii in French Guiana, which is still unknown. Further studies are necessary to identify this reservoir. Identification of this reservoir will improve the understanding of the Q fever epidemic in French Guiana and will provide new tools to control this public health problem. © The American

2014 American Journal of Tropical Medicine & Hygiene PubMed

155. Suspected person-to-person transmission of Q fever among hospitalized pregnant women. (Full text)

Suspected person-to-person transmission of Q fever among hospitalized pregnant women. We report a case of suspected patient-to-patient transmission of Q fever among pregnant women in a high-risk pregnancy unit, presumably via aerosolization of vaginally excreted infectious placental particles. This case questions whether current infection control guidelines are sufficient for Q fever-infected women in similar settings.

2014 Clinical Infectious Diseases PubMed

156. Immunogenicity of the Q fever skin test. (PubMed)

Immunogenicity of the Q fever skin test. The Q fever skin test is used to measure cell-mediated immunity to Coxiella burnetii in pre-vaccination screening to exclude individuals with pre-existing immunity. We investigated whether this in-vivo test influences subsequent measurements of immune response.We assessed the humoral and cellular immune responses before, and 6 and 12 months after skin testing in 63 individuals who were not vaccinated because of either a positive skin test or positive (...) at 6 months (P = 0.009) and 223 ± 91 pg/mL at 12 months (P = 0.17). Of the 28 subjects with positive serology (and unknown skin test results), 21/28 (75%) showed an increase in IgG anti-phase I titres at 6 months, and 11/25 (44%) at 12 months. The mean ± SE specific IFN-γ production was significantly increased at 6 months, but not at 12 months.Q fever skin testing causes higher antibody titres and higher in-vitro IFN-γ to C. burnetii, and therefore affects subsequent Q fever diagnostics.Copyright ©

2014 Journal of Infection

157. Serious long-term health consequences of Q-fever and Legionnaires' disease. (PubMed)

Serious long-term health consequences of Q-fever and Legionnaires' disease. We assessed and compared the long-term health status of Q-fever patients and patients with Legionnaires' disease.Q-fever patients and patients with Legionnaires' disease fulfilling the Dutch notification criteria filled out a questionnaire at one year after onset of illness. The proportion of patients with an abnormal score was calculated for 12 health status subdomains and mean scores for the most relevant subdomains (...) were compared between the patient groups.We included 309 Q-fever patients and 190 patients with Legionnaires' disease in the study. A large proportion of the two patient groups was negatively affected on many of the subdomains, especially 'Fatigue', 'General Quality of Life' and 'Role Physical'. We assessed health status of the patient groups using a multivariate regression analysis and found no significant difference for 'Fatigue' and 'General Quality of Life'. Only for the subdomain 'Role

2014 Journal of Infection

158. Persistent Q fever and ischaemic stroke in elderly patients. (Full text)

Persistent Q fever and ischaemic stroke in elderly patients. Whether persistent or chronic Q fever may act as a risk factor for stroke is unknown. A case-control study was conducted in the Hospital Universitario de Burgos (Spain) between February 2011 and December 2012. A total of 803 samples from 634 consecutive hospitalized patients ≥65 years old were tested, of whom 111 were cases (patients with prevalent or incident ischaemic stroke and/or transient ischaemic attack) and 523 were controls (...) (patients without ischaemic stroke and/or transient ischaemic attack). Immunoglobulin G (IgG) antibody titres phase I and II against Q fever, and IgG antibodies levels against Chlamydia pneumoniae and cytomegalovirus (CMV), were determined using immunofluorescence assay and ELISA methods, respectively. Phase I IgG titres against Coxiella burnetii ≥1:256 (compatible with chronic or persistent Q fever) were detected in 16 of 110 (14.5%) cases and in 32 of 524 (6.1%) controls; P = .004, odds ratio (OR) 2.6

2014 Clinical Microbiology and Infection PubMed

159. Persistent high antibody titres against Coxiella burnetii after acute Q fever not explained by continued exposure to the source of infection: a case¿control study. (Full text)

Persistent high antibody titres against Coxiella burnetii after acute Q fever not explained by continued exposure to the source of infection: a case¿control study. From 2007 to 2010, (the southern part of) the Netherlands experienced a large Q fever epidemic, with more than 4,000 reported symptomatic cases. Approximately 1 - 5% of the acute Q fever patients develop chronic Q fever. A high IgG antibody titre against phase I of Coxiella burnetii during follow-up is considered a marker of chronic (...) Q fever. However, there is uncertainty about the significance and cause of persistence of high IgG phase I antibody titres in patients that do not have any additional manifestations of chronic Q fever. We studied whether continued or repeated exposure to the source of infection could explain elevated IgG phase I antibody levels.A case-control study was performed to analyze predictors for possible chronic Q fever. Possible chronic Q fever cases (n = 53) are patients with phase I IgG antibody

2014 BMC Infectious Diseases PubMed

160. Q Fever Reporting: Tip of the Iceberg? (Full text)

Q Fever Reporting: Tip of the Iceberg? 25404072 2015 04 20 2018 12 02 1476-1645 92 2 2015 Feb The American journal of tropical medicine and hygiene Am. J. Trop. Med. Hyg. Q Fever reporting: tip of the iceberg? 217-8 10.4269/ajtmh.14-0636 Hartzell Joshua D JD Infectious Diseases Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland joshua.d.hartzell.mil@mail.mil. eng Editorial Comment 2014 11 17 United States Am J Trop Med Hyg 0370507 0002-9637 AIM IM (...) Am J Trop Med Hyg. 2015 Feb;92(2):247-55 25404080 Am J Trop Med Hyg. 2015 Feb;92(2):244-6 25404074 Animals Female Humans Male Q Fever epidemiology 2014 11 19 6 0 2014 11 19 6 0 2015 4 22 6 0 ppublish 25404072 ajtmh.14-0636 10.4269/ajtmh.14-0636 PMC4347312 Am J Trop Med Hyg. 2015 Feb;92(2):247-55 25404080 Am J Trop Med Hyg. 2015 Feb;92(2):244-6 25404074 Vector Borne Zoonotic Dis. 2002 Fall;2(3):179-91 12737547 Clin Microbiol Infect. 2006 May;12 Suppl 3:12-24 16669925 Am J Trop Med Hyg. 2009 Oct;81

2014 American Journal of Tropical Medicine & Hygiene PubMed

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