Q Fever (Coxiella burnetii)

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 224 Q Fever (Coxiella burnetii)

Q fever (for query fever, the name given following an outbreak of febrile illness in an abattoir in Queensland, Australia) is rarely reported in children but is probably underdiagnosed. Symptomatic patients can have acute or chronic disease.

Epidemiology

The disease is reported worldwide, except in New Zealand. Although seroepidemiologic studies suggest that infection occurs just as often in children as in adults, children less often present with clinical disease than do adults. Approximately 60% of infections are asymptomatic, and only 5% of symptomatic patients require hospitalization. Seroprevalence surveys show that 6-70% of children in endemic European and African communities have evidence of past infection, and in France the overall incidence of Q fever is estimated to be 50 cases per 100,000 persons. Cases in Africa are likely misdiagnosed as malaria. Reported cases of Q fever in the USA have increased by 6.5-fold from 26 cases in 2001 to 171 cases in 2007, which might reflect an increase in incidence, increased reporting after September 11, 2001, improved diagnostic tools, or a combination of factors. Reported cases in Asia and Australia have also increased. Most infections in children are identified during the lamb birthing season in Europe (January through June), following farm visits, or after exposure to placentas of dogs, cats, and rabbits. The largest community outbreak ever described occurred in the southeastern part of the Netherlands in 2008 and was associated with intensive goat farming. More than 20% of cases of clinically recognized acute or chronic Q fever occur in immunosuppressed hosts or in persons with prosthetic valves or damaged native valves or vessels. Although infections are recognized more often in men than in women, reported cases in boys and girls are equal.