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Epidemiology and clinical features of human infection with Coxiella burnetii in Denmark during 2006-07.
Zoonoses Public Health. 2012 Feb; 59(1):61-8.ZP

Abstract

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.

Authors+Show Affiliations

European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden. cci@ssi.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21824371

Citation

Bacci, S, et al. "Epidemiology and Clinical Features of Human Infection With Coxiella Burnetii in Denmark During 2006-07." Zoonoses and Public Health, vol. 59, no. 1, 2012, pp. 61-8.
Bacci S, Villumsen S, Valentiner-Branth P, et al. Epidemiology and clinical features of human infection with Coxiella burnetii in Denmark during 2006-07. Zoonoses Public Health. 2012;59(1):61-8.
Bacci, S., Villumsen, S., Valentiner-Branth, P., Smith, B., Krogfelt, K. A., & Mølbak, K. (2012). Epidemiology and clinical features of human infection with Coxiella burnetii in Denmark during 2006-07. Zoonoses and Public Health, 59(1), 61-8. https://doi.org/10.1111/j.1863-2378.2011.01419.x
Bacci S, et al. Epidemiology and Clinical Features of Human Infection With Coxiella Burnetii in Denmark During 2006-07. Zoonoses Public Health. 2012;59(1):61-8. PubMed PMID: 21824371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology and clinical features of human infection with Coxiella burnetii in Denmark during 2006-07. AU - Bacci,S, AU - Villumsen,S, AU - Valentiner-Branth,P, AU - Smith,B, AU - Krogfelt,K A, AU - Mølbak,K, Y1 - 2011/05/20/ PY - 2011/8/10/entrez PY - 2011/8/10/pubmed PY - 2012/10/16/medline SP - 61 EP - 8 JF - Zoonoses and public health JO - Zoonoses Public Health VL - 59 IS - 1 N2 - 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. SN - 1863-2378 UR - https://www.unboundmedicine.com/medline/citation/21824371/Epidemiology_and_clinical_features_of_human_infection_with_Coxiella_burnetii_in_Denmark_during_2006_07_ L2 - https://doi.org/10.1111/j.1863-2378.2011.01419.x DB - PRIME DP - Unbound Medicine ER -