A large Q fever outbreak in the West Midlands: clinical aspects

Smith, D L; Ayres, Jonathan Geoffrey; Blair, Iain; Burge, PS; Carpenter, Matthew J.; Caul, E.O.; Coupland, Ben; Desselberger, Ulrich; Evans, Meirion Rhys; Farrell, I. D.; Hawker, Jeremy; Smith, E.G.; Wood, Martin

doi:10.1016/0954-6111(93)90006-l

Cited by 62 publications

(44 citation statements)

References 22 publications

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“…The rates of elevated LDH and total bilirubin, as well as thrombocytopenia were more frequent than those reported in field literature, 1,5,15,60,61 probably due to the greater prevalence of liver involvement in this sample. Some studies have suggested a possible autoimmune abnormality associated with liver involvement in Q fever, but this is yet to be clarified.…”

Section: Discussioncontrasting

confidence: 49%

“…59 Table II illustrates the frequency of symptoms, signs and laboratory abnormalities in the patients in this sample and compares them with the results compiled by Maurin and Raoult, published to date. 1,26,27,41,60 The most frequent abnormalities found in the physical examination were abnormal pulmonary auscultation, hepatomegaly and splenomegaly. The prevalence of hepatosplenomegaly in the current study was higher than that reported in most studies, 1,17 probably due to the greater prevalence of liver involvement in this sample.…”

Section: Discussionmentioning

confidence: 99%

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cute Q fever in Portugal. Epidemiological and clinical features of 32 hospitalized patients

Palmela¹,

Badura²,

Valadas³

2012

GERMS

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

cute Q fever in Portugal. Epidemiological and clinical features of 32 hospitalized patients

Palmela¹,

Badura²,

Valadas³

2012

GERMS

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“…Previous or current participation in agricultural activities or livestock farming were considered to be risk factors for the infection [4]. A large outbreak in an urban area in the United Kingdom was also recently reported, and windbome spread form surrounding farmlands was proposed as the route of infection [16]. In southern Sweden, 24-30 % of sheep farmers and 12% of veterinarians have been exposed to C. burnetii; although in the non-risk groups of draftees and hospital employees, 5-7% were also sero-positive [17].…”

Section: Discussionmentioning

confidence: 99%

High incidence of Coxiella burnetii markers in a rural population in France

et al. 1996

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Since Coxiella burnetii, the causative agent of Q fever, is often transmitted from goats and sheep to humans through aerosols, we examined the sera from 168 persons involved in goat breeding in the Centre region of France and 40 members of veterinary and medical staff from the same region for the presence of antibodies against C. burnetii. An immunofluorescence assay was used to detect the presence of antibodies of the IgG isotope against epitopes from phase II of C. burnetii, which are the first antibodies to appear in infected people, and from phase I, which reflect more chronic stages of the infection. Our serological survey showed that most of the tested sera were positive for C. burnetii markers, indicating at least an encounter with the bacterium. In the overall population of 208 subjects, 71% of the sera had antibodies against phase II epitopes (titres > or = 1:40). Among the goat farmers and their immediate families, 78% had antibodies against phase II and 33% against phase I (titres > or = 1:40). Considering only high titres (> or = 1:320), though, only 37% of the farmers had antibodies against phase II and 15% against phase I. Only 3 out of 12 veterinarians working in the field had high titres of antibodies against phase II and phase I, while none of 28 members of veterinary and medical laboratories had significant levels of antibodies. These results emphasize the need for closer surveillance of populations at risk for Q fever, to prevent the infection by C. burnetii from reaching chronic stages of the disease.

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“…Possible peripheral nervous system involvement has been recorded in only six of 1,885 cases in five large case series [7][8][9][10][11][12]. A much higher prevalence of neurological manifestations occurred in two reports from the United Kingdom [13,14]. In these reports 22% and 23% of cases experienced neurological manifestations with nine of 163 (5.5%) cases experiencing symptoms possibly referable to the peripheral nervous system.…”

Section: Discussionmentioning

confidence: 95%