Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec;38(6):471-7.
doi: 10.1007/s15010-010-0052-x. Epub 2010 Sep 21.

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

G J M Limonard  1 , M H Nabuurs-Franssen, G Weers-Pothoff, C Wijkmans, R Besselink, A M Horrevorts, P M Schneeberger, C A R Groot
Affiliations

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

G J M Limonard et al. Infection. 2010 Dec.

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.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
One-year serological follow-up of patients with acute Q fever by complement fixation test (CFT; antibodies to phase II) and immunofluorescence assay (IFA; IgG- and IgM-antibodies to phase I and phase II). The horizontal bars represent the mean
See this image and copyright information in PMC

References

    1. Karagiannis I, Morroy G, Rietveld A, et al. Q fever outbreak in the Netherlands: a preliminary report. Euro Surveill. 2007;12:E070809.2–2003. - PubMed
    1. Van Steenbergen JE, Morroy G, Groot CA, et al. An outbreak of Q fever in The Netherlands—possible link to goats. Ned Tijdschr Geneeskd. 2007;151:1998–2003. - PubMed
    1. Karagiannis I, Schimmer B, Van Lier A, et al. Investigation of a Q fever outbreak in a rural area of The Netherlands. Epidemiol Infect. 2009;137:1283–1294. doi: 10.1017/S0950268808001908. - DOI - PubMed
    1. Maurin M, Raoult D. Q fever. Clin Microbiol Rev. 1999;12:518–553. - PMC - PubMed
    1. Parker NR, Barralet JH, Bell AM. Q fever. Lancet. 2006;367:679–688. doi: 10.1016/S0140-6736(06)68266-4. - DOI - PubMed

LinkOut - more resources