Influenza B, Q Fever and the consequences of febrile illness occurring during Jungle Warfare Training: a clinical and serological study

1989 ◽  
Vol 75 (1) ◽  
pp. 13-18
Author(s):  
M. C. J. Wale
Keyword(s):  
Q Fever ◽  
Febrile Illness ◽  
Influenza B ◽  
Serological Study ◽  
Serological Evidence ◽  
Heat Exhaustion ◽  
Acute Q Fever

AbstractSeventy-one Royal Marines undergoing jungle warfare training were studied clinically and serologically to determine the incidence and consequences of febrile illness. During acclimatisation and the early part of the deployment the incidence of illness having an impact on training was low; during the latter part an outbreak of influenza B occurred, with 25 cases diagnosed clinically. Only 12 of these were confirmed serogically, probably because the outbreak was still in progress when the second samples were taken. A further four subclinical cases were uncovered by the serological study.Five cases of heat exhaustion occurred, one Marine suffering two episodes. Four patients required casevac from the jungle. Three Marines were found to have serological evidence of previous acute Q fever, including the patient who had two episodes of heat exhaustion. This incidence is higher than expected, and warrants further investigation.

scholarly journals Epidemiological, clinical and laboratory characteristics of acute Q fever in an endemic area in Israel, 2006–2016

2019 ◽  
Vol 147 ◽  
Author(s):  
S. Reisfeld ◽  
S. Hasadia Mhamed ◽  
M. Stein ◽  
M. Chowers
Keyword(s):  
Endemic Area ◽  
Q Fever ◽  
Febrile Illness ◽  
Definite Diagnosis ◽  
Febrile Patient ◽  
Rural Regions ◽  
Historical Cohort ◽  
Common Mean ◽  
Acute Q Fever ◽  
Autumn And Winter

AbstractOur purpose was to describe the clinical, epidemiological and laboratory characteristics of patients hospitalised with acute Q fever in an endemic area of Israel. We conducted a historical cohort study of all patients hospitalised with a definite diagnosis of acute Q fever, and compared them to patients suspected to have acute Q fever, but diagnosis was ruled out. A total of 38 patients had a definitive diagnosis, 47% occurred during the autumn and winter seasons, only 18% lived in rural regions. Leucopaenia and thrombocytopaenia were uncommon (16% and 18%, respectively), but mild hepatitis was common (mean aspartate aminotransferase 76 U/l, mean alanine aminotransferase 81 U/l). We compared them with 74 patients in which acute Q fever was ruled out, and found that these parameters were not significantly different. Patients with acute Q fever had a shorter hospitalisation and they were treated more often with doxycycline than those without acute Q fever (6.4vs. 14 days,P= 0.007, 71%vs. 38%,P= 0.001, respectively). In conclusion, acute Q fever can manifest as an unspecified febrile illness, with no seasonality. We suggest that in endemic areas, Q fever should be considered in the differential diagnosis in any febrile patient with risk factors for a persistent infection.

scholarly journals Q Fever

1999 ◽  
Vol 12 (4) ◽  
pp. 518-553 ◽  
Author(s):  
M. Maurin ◽  
D. Raoult
Keyword(s):  
Q Fever ◽  
Febrile Illness ◽  
Protective Role ◽  
Immunoglobulin M ◽  
Worldwide Distribution ◽  
Cell Extracts ◽  
Chronic Q Fever ◽  
Acute Q Fever ◽  
High Level ◽  
Immunocompromised Hosts

SUMMARY Q fever is a zoonosis with a worldwide distribution with the exception of New Zealand. The disease is caused by Coxiella burnetii, a strictly intracellular, gram-negative bacterium. Many species of mammals, birds, and ticks are reservoirs of C. burnetii in nature. C. burnetii infection is most often latent in animals, with persistent shedding of bacteria into the environment. However, in females intermittent high-level shedding occurs at the time of parturition, with millions of bacteria being released per gram of placenta. Humans are usually infected by contaminated aerosols from domestic animals, particularly after contact with parturient females and their birth products. Although often asymptomatic, Q fever may manifest in humans as an acute disease (mainly as a self-limited febrile illness, pneumonia, or hepatitis) or as a chronic disease (mainly endocarditis), especially in patients with previous valvulopathy and to a lesser extent in immunocompromised hosts and in pregnant women. Specific diagnosis of Q fever remains based upon serology. Immunoglobulin M (IgM) and IgG antiphase II antibodies are detected 2 to 3 weeks after infection with C. burnetii, whereas the presence of IgG antiphase I C. burnetii antibodies at titers of ≥1:800 by microimmunofluorescence is indicative of chronic Q fever. The tetracyclines are still considered the mainstay of antibiotic therapy of acute Q fever, whereas antibiotic combinations administered over prolonged periods are necessary to prevent relapses in Q fever endocarditis patients. Although the protective role of Q fever vaccination with whole-cell extracts has been established, the population which should be primarily vaccinated remains to be clearly identified. Vaccination should probably be considered in the population at high risk for Q fever endocarditis.

scholarly journals Acute Q Fever Case Detection among Acute Febrile Illness Patients, Thailand, 2002–2005

2018 ◽  
Vol 98 (1) ◽  
pp. 252-257 ◽  
Author(s):  
Ashley L. Greiner ◽  
Christopher J. Gregory ◽  
Saithip Bhengsri ◽  
Sophie Edouard ◽  
Philippe Parola ◽  
...  
Keyword(s):  
Q Fever ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Case Detection ◽  
Fever Case ◽  
Acute Q Fever

scholarly journals 211. Coxiella burnetii: 7 Years of Experience at a Tertiary-Care Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S124-S125
Author(s):  
Pooja Gurram ◽  
F N U Shweta ◽  
Natalia E Castillo Almeida ◽  
Sarwat Khalil ◽  
Edison J Cano Cevallos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coxiella Burnetii ◽  
Persistent Infection ◽  
Q Fever ◽  
Care Center ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Case Definition ◽  
Common Presentation ◽  
Acute Q Fever

Abstract Background Q fever is a zoonotic disease caused by Coxiella burnetii. Primary infection can progress to persistent infection irrespective of initial symptomatology. Our aim is to describe the clinical features, treatment, risk of progression, use of prophylaxis, and outcomes of Coxiella burnetii infection at our institution. Methods We did a retrospective review of all adult patients with positive Coxiella burnetii serology at Mayo Clinic, Rochester from 1st January 2012 to 31st December 2018. Centers for Disease Control and Prevention (CDC) case definition and classification were used to group the patients into confirmed and probable acute Q fever, and confirmed and probable chronic/persistent Q fever. Data on demographics, clinical presentation, comorbid conditions, exposure history, risk factors associated with progression, serology, treatment and outcomes were collected. Results We found 266 patients with positive titres of Coxiella IgG or IgM greater than 1:16, of which 49 patients met the CDC case definition for Q fever. Median age at presentation was 62 years. 45/49 (91. 8%) were men, while 4/49 (8%) were women. 20/49 (40. 8%) patients presented with acute Q fever of which 5 (25%) patients progressed to persistent infection. 29/49 (59%) patients presented with persistent Q fever of which 4 patients could recall symptoms suggestive of acute Q fever. The most common presentation of acute Q fever was acute febrile illness (65%). Endocarditis (11/29) was the most common presentation of chronic/persistent Q fever. Of the 5 patients with acute Q fever that progressed to persistent infection, 3/5(60%) progressed despite being on doxycycline and hydroxychloroquine. 8/29 patients with persistent Q fever had serological resolution at last follow-up. 2/4(50%) deaths were attributable to Q fever. Conclusion Minority of the patients tested met the case definition. 25% of patients with acute disease progressed to chronic Q fever out of which 60%(3/5) progressed despite prophylaxis. Endocarditis and vascular infections were the most common chronic cases. Interestingly we found 4 cases of MPGN in association with Q fever. Prosthetic valves are the most important risk factors for progression (P = 0.02). Serological cure often lags behind clinical cure (27% vs. 68% in persistent infection)(Table 4). Disclosures All authors: No reported disclosures.

scholarly journals Seroepidemiology ofCoxiella burnetiiInfection and its Frequency as a Cause of Community-Acquired Pneumonia in Canada

2002 ◽  
Vol 13 (3) ◽  
pp. 164-166 ◽  
Author(s):  
Thomas J Marrie ◽  
Emidio de Carolis ◽  
Keyword(s):  
Coxiella Burnetii ◽  
Q Fever ◽  
Community Acquired Pneumonia ◽  
Serological Evidence ◽  
Serum Samples ◽  
Canadian Provinces ◽  
Acute Q Fever

The present study tested acute and convalescent serum samples from 788 patients hospitalized for community-acquired pneumonia in seven Canadian provinces for antibodies toCoxiella burnetii. One hundred nine patients (13.8%) had antibodies to this microorganism, and seven patients had acute Q fever. Serological evidence of infection withC burnetiiwas present in patients from all seven provinces. Three of the seven cases of acute Q fever were from Manitoba, suggesting that there may be unrecognized cases of Q fever in this province. In addition, a case of acute Q fever in Newfoundland, where there had previously been no reported cases, was noted, although subsequently, an outbreak of Q fever on goat farms has been reported.

scholarly journals Epidemiological investigation and physician awareness regarding the diagnosis and management of Q fever in South Korea, 2011 to 2017

2021 ◽  
Vol 15 (6) ◽  
pp. e0009467
Author(s):  
Yong Chan Kim ◽  
Hye Won Jeong ◽  
Dong-Min Kim ◽  
Kyungmin Huh ◽  
Sang-Ho Choi ◽  
...  
Keyword(s):  
South Korea ◽  
Online Survey ◽  
Q Fever ◽  
Management Strategies ◽  
Febrile Illness ◽  
Clinical Severity ◽  
Diagnosis And Management ◽  
Chronic Q Fever ◽  
Physician Awareness ◽  
Acute Q Fever

Background In South Korea, the number of Q fever cases has rapidly increased since 2015. Therefore, this study aimed to characterize the epidemiological and clinical features of Q fever in South Korea between 2011 and 2017. Methods/Principal findings We analyzed the epidemiological investigations and reviewed the medical records from all hospitals that had reported at least one case of Q fever from 2011 to 2017. We also conducted an online survey to investigate physicians’ awareness regarding how to appropriately diagnose and manage Q fever. The nationwide incidence rate of Q fever was annually 0.07 cases per 100,000 persons annually. However, there has been a sharp increase in its incidence, reaching up to 0.19 cases per 100,000 persons in 2017. Q fever sporadically occurred across the country, with the highest incidences in Chungbuk (0.53 cases per 100,000 persons per year) and Chungnam (0.27 cases per 100,000 persons per year) areas. Patients with acute Q fever primarily presented with mild illnesses such as hepatitis (64.5%) and isolated febrile illness (24.0%), whereas those with chronic Q fever were likely to undergo surgery (41.2%) and had a high mortality rate (23.5%). Follow-up for 6 months after acute Q fever was performed by 24.0% of the physician respondents, and only 22.3% of them reported that clinical and serological evaluations were required after acute Q fever diagnosis. Conclusions Q fever is becoming an endemic disease in the midwestern area of South Korea. Given the clinical severity and mortality of chronic Q fever, physicians should be made aware of appropriate diagnosis and management strategies for Q fever.

scholarly journals Clinical characteristics of acute Q fever patients in South Korea and time from symptom onset to serologic diagnosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jung Yeon Heo ◽  
Young Wha Choi ◽  
Eun Jin Kim ◽  
Seung Hun Lee ◽  
Seung Kwan Lim ◽  
...  
Keyword(s):  
South Korea ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Q Fever ◽  
Febrile Illness ◽  
Serologic Diagnosis ◽  
Animal Contact ◽  
History Of ◽  
Acute Q Fever ◽  
High Phase

Abstract Background Acute Q fever usually presents as a nonspecific febrile illness, and its occurrence is rapidly increasing in South Korea. This study investigated the clinical characteristics of acute Q fever patients in South Korea and the time from symptom onset to serologic diagnosis. The clinical courses were examined according to antibiotic treatment. Methods Data of patients diagnosed with acute Q fever at Chungbuk National University Hospital between January 2015 and February 2018 were retrospectively collected. Demographic and epidemiologic data were reviewed. The time from symptom onset to serologic diagnosis by an immunofluorescence assay (IFA) was analyzed. Clinical courses and the percentage of patients with a high phase I immunoglobulin G titer (≥ 1:1024) were compared between patients administered antibiotics with anti-Coxiella burnetii activity and patients not administered such antibiotics. Results Forty-eight patients (median age: 51.5 years) were included. Most were male (95.8%) and had no history of animal contact (91.7%). The median time from illness onset to serologic diagnosis was 21 days. Thirty-nine patients received antibiotics with anti-C. burnetii activity. The length of hospital stay and fever duration did not significantly differ between patients who received antibiotics with anti-C. burnetii activity (7 and 15 days) and those who did not (5 and 8 days) (P = 0.110 and P = 0.137, respectively). The percentage of patients with a high phase I immunoglobulin G titer (≥ 1:1024) did not significantly differ between patients who received antibiotics with anti-C. burnetii activity and those who did not (P = 0.340). Conclusions Most acute Q fever patients had a nonspecific febrile illness with mild elevation of transaminases and no history of animal contact or occupational risk. The time from symptom onset to a positive IFA test was longer than the fever duration in most acute Q fever patients. Consequently, it may be difficult for clinicians to serologically diagnose acute Q fever. However, inappropriate antibiotic treatment was not associated with prolongation of symptoms or progression to chronic Q fever.

scholarly journals Q Fever Vaccine Development: Current Strategies and Future Considerations

Pathogens ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1223
Author(s):  
Carrie Mae Long
Keyword(s):  
Vaccine Development ◽  
Q Fever ◽  
Febrile Illness ◽  
Cell Vaccine ◽  
Environmental Persistence ◽  
Post Vaccination ◽  
Area Of Interest ◽  
Whole Cell Vaccine ◽  
History Of ◽  
Acute Q Fever

Q fever is a zoonotic disease caused by the intracellular pathogen Coxiella burnetii. This disease typically manifests as a self-limiting, febrile illness known as acute Q fever. Due to the aerosol transmissibility, environmental persistence, and infectivity of C. burnetii, this pathogen is a notable bioterrorism threat. Despite extensive efforts to develop next-generation human Q fever vaccines, only one vaccine, Q-Vax®, is commercially available. Q-Vax® is a phase I whole-cell vaccine, and its licensed use is limited to Australia, presumably due to the potential for a post-vaccination hypersensitivity response. Pre-clinical Q fever vaccine development is a major area of interest, and diverse approaches have been undertaken to develop an improved Q fever vaccine. Following a brief history of Q fever vaccine development, current approaches will be discussed along with future considerations for an improved Q fever vaccine.

Q fever: a rare but potentially life-threatening zoonotic disease

2021 ◽  
Vol 14 (2) ◽  
pp. e237155
Author(s):  
Pranav Mahajan ◽  
Kailash Pant ◽  
Shirin Majdizadeh
Keyword(s):  
Chronic Disease ◽  
Cardiovascular System ◽  
Q Fever ◽  
Acute Infection ◽  
Acute Illness ◽  
Unknown Aetiology ◽  
Severe Hepatitis ◽  
The Usa ◽  
Life Threatening ◽  
Acute Q Fever

Q fever can present as a fever of unknown aetiology and can be challenging to diagnose because of the rare incidence. It can present as an acute illness with manifestations, including influenza-like symptoms, hepatitis, pneumonia or chronic disease involving the cardiovascular system. We present a case of a 39-year-old woman in the USA, who developed acute Q fever with associated sepsis and severe hepatitis. She received treatment with recovery from acute infection but currently has symptoms of post Q fever syndrome.

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