Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak

Morroy, G.; Hoek, Wim van der; Albers, Jelle; Coutinho, Roel A.; Bleeker‐Rovers, Chantal P.; Schneeberger, Peter M.

doi:10.1371/journal.pone.0131777

Cited by 22 publications

(38 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As a consequence of the epidemic, many patients with underlying cardiac valve (or vascular) defects or prostheses could have been exposed to C. burnetii and might develop life-threatening endocarditis or vascular infections (76)(77)(78). Also, a high number of pregnant women could have been exposed to C. burnetii and might develop obstetrical complications and spontaneous abortions (79).…”

Section: The Different Epidemiological Profilesmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

View full text Add to dashboard Cite

Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.

show abstract

Section: The Different Epidemiological Profilesmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

View full text Add to dashboard Cite

show abstract

“…From 2007 to 2010, a large outbreak of Q fever infected many individuals in the Netherlands. Although the epidemic ended in 2010, new chronic Q fever patients are still diagnosed in 2016 [4,5]. How C. burnetii persists and eventually causes chronic infection in these patients is still largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Involvement of matrix metalloproteinases in chronic Q fever

Jansen

Schoffelen

Textoris

et al. 2017

Clinical Microbiology and Infection

View full text Add to dashboard Cite

show abstract

“…For this scenario, we used larger geographic areas (3-digit postal code areas) and C. burnetii seroprevalences for each incidence area from the literature (24,25). In the second step, we estimated the risk for CQF using targeted screening studies for CQF conducted during or immediately after the epidemic (Appendix Table 4) (9)(10)(11)26,27). In the third step, we based the adjustment of the CQF prevalence from directly after the epidemic to the year of screening for the low CQF prevalence scenario on the reduction of CQF patients in the national CQF database over time (28).…”

Section: Cqf Prevalencementioning

confidence: 99%

“…We assumed a participation rate in the screening program of 50%, which is the lower bound of previous targeted screening programs for CQF in the Netherlands (10,27,30). The prevalence of CQF was assumed to be equal between participating and nonparticipating persons; hence, the participation rate affects only the number of CQF patients detected but not the cost-effectiveness of screening.…”

Section: Detection Rate Of Screening and Regular Carementioning

confidence: 99%

Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands

Boer¹,

Lange²,

Wielders³

et al. 2020

Emerg. Infect. Dis.

Self Cite

View full text Add to dashboard Cite

C hronic Q fever (CQF) is a potentially lethal condition that develops in 2% of Q fever (QF) patients (1). QF is caused by infection with Coxiella burnetii, a gram-negative bacterium that has its main reservoir in livestock and can infect humans by airborne transmission. CQF can become apparent months to years after infection and usually manifests as endocarditis or vascular infection (2). Risk factors for CQF include heart valve disorders, aortic aneurysms, vascular prostheses, older age, and a compromised immune system (3-5). Prognosis is poor despite long-term antimicrobial drug treatment; 28% of patients need surgery, and 15% die from CQF-related complications (6). During 2007-2010, the Netherlands faced the world's largest QF epidemic ever documented. More than 4,000 patients with acute QF were notified. However, QF often occurs asymptomatically (1), and the total number of infections has been estimated at 50,000 (7). Through May 2016, a substantial number of CQF infections occurred, and at least 74 patients died (8). Because early detection of CQF might result in a better prognosis, local hospitals initiated multiple targeted screening studies for clinical risk groups living in areas affected by the epidemic. These studies revealed that 7%-20% of screened patients had serologic evidence of C. burnetii infection, of whom 5%-31% had CQF (9-11). In 2017, new diagnoses of CQF continued to appear in the Netherlands, often with severe complications, and led to a call from multiple concerned parties, including politicians, the QF patient association, and medical doctors for a national CQF screening program. One aspect considered for such a screening program is whether its costs are economically balanced with the expenditure (12,13). To answer this question, we assessed the cost-effectiveness of a screening program for CQF in the Netherlands. Methods Overview We developed a health-economic decision model to compare estimated costs and effects of a 1-time screening program for CQF with no such screening program (Figure 1). The screening was assumed to occur in 2017, seven years after the epidemic. We estimated comparative outcomes of the model in terms of clinical events, quality-adjusted life years (QALYs), and costs from a societal perspective. We used a lifetime time horizon. Costs were annually discounted at 4% and QALYs at 1.5% (14).

show abstract

Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak

Cited by 22 publications

References 14 publications

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

Involvement of matrix metalloproteinases in chronic Q fever

Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands

Contact Info

Product

Resources

About