Epidemiology of Q fever in Sweden

Åkesson, Åke; Macellaro, Anna; Tüll, Peet; Williams, Jim C.; Norlander, Lena

doi:10.3109/00365549109023393

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…In Switzerland approximately 10% of the urban population has antibodies to C. burnetii, and in selected rural areas antibody prevalence may be as high as 31% (5). Studies from other countries have found similar results (2,12). In the United States disease due this organism is thought to be unusual.…”

supporting

confidence: 72%

Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

et al. 1995

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Coxiella burnetii was isolated from the valve material of two patients who underwent valvectomy because of progressive congestive heart failure due to endocarditis. In each case antibiotic therapy was administered for several months prior to valvectomy. Classical histopathological examination of the valves did not reveal an etiology. However, coxiella-like organisms were demonstrated in valvular material with Köster, Stamp, and Giemsa stains, and the organisms were grown in cell culture. Antibody titers were consistent with the diagnosis of chronic C. burnetii infection. This report illustrates the advantage of simple and fast staining techniques and cell culture for the demonstration and isolation of C. burnetii in the heart valve tissue of patients with Q fever endocarditis.

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supporting

confidence: 72%

Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

et al. 1995

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“…Extending the case definition beyond seropositives to include borderline cases would raise the seroprevalence of infection among those tested from 11% to 22%. Previous studies in Sweden have shown various estimates of seroprevalence: in a survey of sheep farmers in the island of Gotland, the proportion of seropositive was 30% (Akesson et al., 1991); in different areas of Sweden, estimates varied between 12% in a sample of veterinarians and 5–7% in non‐risk groups (Macellaro et al., 1993). In other settings, estimates reported were as high as 60.8% in rural areas of Cyprus (Psaroulaki et al., 2006), or up to 78% in a high risk rural population in central France (Thibon et al., 1996).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Clinical Features of Human Infection with Coxiella burnetii in Denmark During 2006–07

Bacci

Villumsen

Valentiner‐Branth

et al. 2011

Zoonoses and Public Health

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Query (Q) fever was virtually unknown in Denmark in 2005, when, after the introduction of new sensitive diagnostic methods for Coxiella burnetii, an increasing number of positive cattle created concern among people with frequent exposure. This led to a dramatic rise in examinations for Q fever among humans in the following 2 years. The aim of our study was to assess indication for testing and symptoms in individuals with serological signs of infection with C. burnetii. We performed a case-review study of seropositives among all humans tested for Q fever in 2006-07 in Denmark. Seropositive cases were categorized with acute infection: 4-fold increase in immunoglobulin G (IgG) phase II or concomitant IgM phase II ≥ 1 : 256 and IgG phase II ≥ 1 : 1024; and previous infection: IgG phase II ≥ 1 : 1024. A borderline result was defined as: IgG phase II = 1 : 512. Physicians completed a questionnaire retrospectively. Of the 1613 people tested, 177 (11%) were seropositive [37 (2%) acute infection, 140 (9%) previous infection], 180 had a borderline result. Among 127 seropositives responders, 31% were tested due to symptoms compatible with Q fever after a possible exposure to C. burnetii, 64% were asymptomatic and were tested following relevant exposure only; 64% were males, 43% farmers, 39% veterinarians, 84% had been exposed to cattle. The most frequently reported symptoms were asthenia (25%), myalgia (21%), fever (17%) and headache (13%). About two-thirds of seropositives reported asymptomatic infections, and were tested for Q fever because of concern for occupational exposure to cattle. One-third of the seropositives reported symptoms consistent with Q fever, the majority being mild. Our study provided important evidence that increased requests for Q fever testing in 2006-07 arose from heightened public awareness of the disease, and not from an outbreak of clinical disease. Nonetheless, Q fever should be considered endemic in Denmark.

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“…This is a low percentage, especially when milk samples of 61% of Danish diary cattle have been found to be positive for C. burnetii (J. Agerholm, unpublished data). In other countries, this percentage was much higher: 28.5% of Swedish sheep farmers [6] and 27% of English farmers [9] were seropositive, and 17.8% of Polish farmers had IgG phase I antibodies [21]. In Milwaukee, the seropositivity among residents of dairy farms was much higher (28.5%) than in a local control group (2.2%) [22], which was also observed in Maryland (15.3% vs. 0.15%) [23].…”

Section: Discussionmentioning

confidence: 99%

“…Patients that have been infected with C. burnetii remain seropositive and are considered to be immune to acute Q fever for at least some years. Certain professions have an elevated risk of exposure to C. burnetii because of their occupational contact with animals [6–9].…”

Section: Introductionmentioning

confidence: 99%

Emerging evidence for Q fever in humans in Denmark: role of contact with dairy cattle

Bosnjak

Hvass

Villumsen

et al. 2010

Clinical Microbiology and Infection

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Until recently, Q fever was notified in very low numbers annually in Denmark and it was always considered to be acquired abroad. Preliminary reports now describe Coxiella burnetii in milk samples from Danish dairy cattle. Serum samples of a large cohort of farmers, veterinarians, inseminators and hoof trimmers, all having occupational contact with dairy cattle, were tested for the presence of IgG to phase I and phase II antigens of C. burnetii. In 39 of 359 individuals studied (11%), the presence of antibodies to C. burnetii was found. Veterinarians had the highest seropositivity rate (36%). This survey suggests that C. burnetii is a recently recognized domestic infection in Denmark and that risk of infection is associated with occupation.

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Epidemiology of Q fever in Sweden

Cited by 9 publications

References 5 publications

Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

Isolation of Coxiella burnetii from heart valves of patients treated for Q fever endocarditis

Epidemiology and Clinical Features of Human Infection with Coxiella burnetii in Denmark During 2006–07

Emerging evidence for Q fever in humans in Denmark: role of contact with dairy cattle

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