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One-year follow-up of patients of the ongoing Dutch Q fever outbreak: clinical, serological and echocardiographic findings.

Authors :
Limonard, G. J. M.
Nabuurs-Franssen, M. H.
Weers-Pothoff, G.
Wijkmans, C.
Besselink, R.
Horrevorts, A. M.
Schneeberger, P. M.
Groot, C. A. R.
Source :
Infection; Dec2010, Vol. 38 Issue 6, p471-477, 7p, 3 Charts, 1 Graph
Publication Year :
2010

Abstract

Purpose: In 2007, a large goat-farming-associated Q fever outbreak occurred in the Netherlands. Data on the clinical outcome of Dutch Q fever patients are lacking. The current advocated follow-up strategy includes serological follow-up to detect evolution to chronic disease and cardiac screening at baseline to identify and prophylactically treat Q fever patients in case of valvulopathy. However, serological follow-up using commercially available tests is complicated by the lack of validated cut-off values. Furthermore, cardiac screening in the setting of a large outbreak has not been implemented previously. Therefore, we report here the clinical outcome, serological follow-up and cardiac screening data of the Q fever patients of the current ongoing outbreak. Methods: The implementation of a protocol including clinical and serological follow-up at baseline and 3, 6 and 12 months after acute Q fever and screening echocardiography at baseline. Results: Eighty-five patients with acute Q fever were identified (male 62%, female 38%). An aspecific, flu-like illness was the most common clinical presentation. Persistent symptoms after acute Q fever were reported by 59% of patients at 6 months and 30% at 12 months follow-up. We observed a typical serological response to Coxiella burnetii infection in both anti-phase I and anti-phase II IgG antibodies, with an increase in antibody titres up to 3 months and a subsequent decrease in the following 9 months. Screening echocardiography was available for 66 (78%) out of 85 Q fever patients. Cardiac valvulopathy was present in 39 (59%) patients. None of the 85 patients developed chronic Q fever. Conclusions: Clinical, serological and echocardiographic data of the current ongoing Dutch Q fever outbreak cohort are presented. Screening echocardiography is no longer part of the standard work-up of Q fever patients in the Netherlands. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03008126
Volume :
38
Issue :
6
Database :
Complementary Index
Journal :
Infection
Publication Type :
Academic Journal
Accession number :
55983370
Full Text :
https://doi.org/10.1007/s15010-010-0052-x