Risk of chronic Q fever in patients with cardiac valvulopathy, seven years after a large epidemic in the Netherlands.

Background From 2007 through 2010, a large epidemic of acute Q fever occurred in the Netherlands. Patients with cardiac valvulopathy are at high risk to develop chronic Q fever after an acute infection. This patient group was not routinely screened, so it is unknown whether all their chronic infections were diagnosed. This study aims to investigate how many chronic Q fever patients can be identified by routinely screening patients with valvulopathy and to establish whether the policy of not screening should be changed. Methods In a cross-sectional study (2016-2017) in a hospital at the epicent... Mehr ...

Verfasser: Marit M A de Lange
Arko Scheepmaker
Wim van der Hoek
Monique Leclercq
Peter M Schneeberger
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: PLoS ONE, Vol 14, Iss 8, p e0221247 (2019)
Verlag/Hrsg.: Public Library of Science (PLoS)
Schlagwörter: Medicine / R / Science / Q
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27190902
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1371/journal.pone.0221247

Background From 2007 through 2010, a large epidemic of acute Q fever occurred in the Netherlands. Patients with cardiac valvulopathy are at high risk to develop chronic Q fever after an acute infection. This patient group was not routinely screened, so it is unknown whether all their chronic infections were diagnosed. This study aims to investigate how many chronic Q fever patients can be identified by routinely screening patients with valvulopathy and to establish whether the policy of not screening should be changed. Methods In a cross-sectional study (2016-2017) in a hospital at the epicentre of the Q fever epidemic, a blood sample was taken from patients 18 years and older who presented with cardiac valvulopathy. The sample was tested for IgG antibodies against phase I and II of Coxiella burnetii using an immunofluorescence assay. An IgG phase II titre of ≥1:64 was considered serological evidence of a previous Q fever infection. An IgG phase I titre of ≥1:512 was considered suspicious for a chronic infection, and these patients were referred for medical examination. Results Of the 904 included patients, 133 (15%) had evidence of a previous C. burnetii infection, of whom 6 (5%) had a chronic infection on medical examination. Conclusions In a group of high-risk patients with a heart valve defect, we diagnosed new chronic Q fever infections seven years after the epidemic, emphasizing the need for screening of this group to prevent complications in those not yet diagnosed in epidemic areas.