Presentation and diagnosis of acute Q fever in Portugal — A case series

Alves, Joana; Almeida, Fernanda Campos Sousa de; Duro, Raquel; Ferraz, Rita; Silva, Susana; Sobrinho‐Simões, Joana; Sarmento, António

doi:10.1016/j.idcr.2016.11.002

Cited by 9 publications

(5 citation statements)

References 15 publications

(19 reference statements)

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“…Q fever was considered due to inadequate clinical response to non-specific antibiotic treatment. Although Yeşilyurt et al [17] acute hepatitis doxycycline Recovery Köse et al [18] headache + splenomegaly ampiciline/sulbactam and ciprofloxacine…”

Section: Resultsmentioning

confidence: 99%

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Are we aware of Q fever enough? experience from a single centre.

Gözdaş¹,

Sırmatel²,

Karabörk³

et al. 2019

Kocaeli Med J

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ÖZ GİRİŞ: Q ateşi, Coxiella burnetii'nin neden olduğu bir zoonozdur. Başlıca klinik prezentasyonları pnömoni ve hepatit'tir. Bununla birlikte, birçok farklı klinik prezentasyonlar nedeniyle Q ateşini tanımak güç olabilir. Bu çalışmada, kurumumuzdaki Q ateşi olgularının klinik ve laboratuvar özelliklerini sunarak Q ateşi farkındalığını artırmayı amaçladık. GEREÇ ve YÖNTEMLER: Hastanemiz veri tabanındaki Q ateşi tanılı hastalar retrospektif olarak değerlendirilmiştir. Hastaların karakteristikleri, başvurudaki klinik ve laboratuvar değerleri kaydedilmiştir. BULGULAR: Bu çalışmaya toplam altı hasta dahil edilmiştir. En sık ateş, iştahsızlık ve bitkinlik gibi semptomlar olmak üzere çeşitli klinik prezentasyonlar gözlenmiştir. En sık laboratuvar anormalliği tüm hastalarda saptanan CRP yüksekliğiydi, LDH ve transaminaz yüksekliği bunu takip etmekteydi. Gerek LDH yüksekliği gerekse transaminaz yüksekliği dört hastada mevcuttu. SONUÇ: Q ateşini teşhis etmek için kullanılan serolojik yöntemler rutin olarak uygulanmamaktadır, bu yüzden Q ateşi olguları kolayca gözden kaçabilir. Biz inanıyoruz ki, endemik bölgelerde nonspesifik antibiyotik tedavisine yeterli yanıt vermeyen hastalarda Q ateşi daha çok araştırılmalıdır. Anahtar kelimeler: Coxiella burnetii, Q ateşi, TürkiyeABSTRACT BACKGROUND: Q fever is a zoonosis caused by Coxiella burnetii. The main clinical presentations are pneumonia and hepatitis. However, it can be difficult to recognise Q fever due to many different clinical presentations. In this study, we aimed to increase the awareness of Q fever by presenting clinical and laboratory features of Q fever cases from our institution. MATERIALS and METHODS:Patients with a diagnosis of Q fever in our hospital database were evaluated retrospectively. Patient characteristics as well as clinical and laboratory values at presentation were recorded. RESULTS:A total of six patients were included in this study. Various clinical presentation was observed such as fever, anorexia and malaise as the most common symptoms. The most common laboratory abnormality was CRP elevation as being detected in all patients followed by LDH and transaminase elevations. both were found in four patients. CONCLUSION:Serological methods used to diagnose Q fever are not routinely performed, so Q fever cases can be missed easily. We believe that Q fever should be investigated further in patients from endemic regions who did not give adequate response to nonspesific antibiotic treatment.

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Section: Resultsmentioning

confidence: 99%

“…Close contact with cattle, goats or sheeps suggested aerosol transmission of Q fever. Although compatible epidemiological history is very important in the diagnosis, unfortunately, the importance of animal contact can be ignored by the patients (18). So, this important diagnostic clue should be investigated in detail by the physicians.…”

Section: Discussionmentioning

confidence: 99%

Are we aware of Q fever enough? experience from a single centre.

Gözdaş¹,

Sırmatel²,

Karabörk³

et al. 2019

Kocaeli Med J

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“…While considered to remain unaltered, Q fever prevalence in the human population of Portugal is conflicting with European data that shows a clear increase in cases (DGS, ; ECDC, ). Although little is known regarding Q fever in Portugal, a few recent case reports in humans have been linked to animals, highlighting the concern for zoonotic transfer from ruminants (Alves et al., ). It is therefore of the upmost importance to provide results on the circulation of C. burnetii in sheep, so as to implement measures on animal health and control the disease spread to the human population.…”

Section: Resultsmentioning

confidence: 99%

Outbreaks of abortions byCoxiella burnetiiin small ruminant flocks and a longitudinal serological approach on archived bulk tank milk suggest Q fever emergence in Central Portugal

Cruz

Esteves

Nóbrega

et al. 2018

Transbound Emerg Dis

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Q fever is a worldwide zoonotic infectious disease caused by Coxiella burnetii and sheep and goats are known to be the main reservoir for human infection. This study describes the epidemiological and laboratory findings of C. burnetii outbreaks affecting sheep and goat flocks and also provides the results of a prospective serosurvey in bulk tank milk samples to assess C. burnetii circulation in a population of sheep living in close contact to the human population in Central Portugal. In the epizooties, C. burnetii was identified in tissues of the resulting abortions by qPCR. As for the serological survey, 10.2% (95%CI: 4.5-19.2) of the 78 bulk tank milk samples collected in 2015 presented IgG antibodies against C. burnetii. The same farms were visited and sampled in 2016 and 25.6% (95%CI: 16.4-36.8) were positive. This steep increase in the number of anti-C. burnetii farms between the 2015 and 2016 collections showed to be statistically significant (p = 0.020) and is strongly suggestive of Q fever emergence in Central Portugal. Measures on animal health and on disease spread control to the human population should be considered.

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“…In Portugal, only one wild mammal molecular prevalence study has been performed, but red deer and wild boar were negative to C. burnetii [ 6 ]. Other studies performed in Portugal have reported Q fever in domestic ruminants [ 6 , 37 , 38 , 39 , 40 ], dogs and cats [ 41 ], and humans [ 42 , 43 , 44 , 45 ]. Nevertheless, this study is the first report of C. burnetii antibodies in red deer and wild boar in east–central Portugal.…”

Section: Discussionmentioning

confidence: 99%

Seropositivity for Coxiella burnetii in Wild Boar (Sus scrofa) and Red Deer (Cervus elaphus) in Portugal

et al. 2023

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Q fever is caused by the pathogen Coxiella burnetii and is a zoonosis that naturally infects goats, sheep, and cats, but can also infect humans, birds, reptiles, or arthropods. A survey was conducted for the detection of antibodies against C. burnetii in a sample of 617 free-ranging wild ruminants, 358 wild boar (Sus scrofa) and 259 red deer (Cervus elaphus), in east–central Portugal during the 2016–2022 hunting seasons. Only adult animals were sampled in this study. Antibodies specific to C. burnetii were detected using a commercial enzyme-linked immunosorbent assay (ELISA; IDVet®, Montpellier, France) according to the manufacturer’s instructions. The seroprevalence of C. burnetii infection was 1.5% (n = 9; 95% confidence interval [CI]: 0.7–2.8%). Antibodies against C. burnetii were detected in 4/358 wild boar (1.1%; 95% CI: CI: 0.3–2.8%) and 5/259 red deer (1.9%; 0.6–4.5%). Results of the present study indicate that antibodies against C. burnetii were present in wild boar and red deer in Portugal. These findings can help local health authorities to focus on the problem of C. burnetii in wildlife and facilitate the application of a One Health approach to its prevention and control.

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Presentation and diagnosis of acute Q fever in Portugal — A case series

Cited by 9 publications

References 15 publications

Are we aware of Q fever enough? experience from a single centre.

Are we aware of Q fever enough? experience from a single centre.

Outbreaks of abortions byCoxiella burnetiiin small ruminant flocks and a longitudinal serological approach on archived bulk tank milk suggest Q fever emergence in Central Portugal

Seropositivity for Coxiella burnetii in Wild Boar (Sus scrofa) and Red Deer (Cervus elaphus) in Portugal

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