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Volume 14, Number 10—October 2008

Research

Prophylaxis after Exposure to Coxiella burnetii

Claire E. MoodieComments to Author , Herbert A. Thompson, Martin I. Meltzer, and David L. Swerdlow
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

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Table 1

Input values used in the primary and secondary analyses of PEP efficacy*

Variable Primary analysis
(sensitivity analysis) Sensitivity analyses
References
Less virulent More virulent
Exposure (0.10, 0.25, 0.50, 1.00) NA NA NA
Efficacy of doxycycline PEP (8–12 d postexposure) 0.82 (0.82–0.965) 0.965 0.40 (22,23)
Efficacy of trimethoprim-sulfamethoxazole PEP (8–12 d postexposure) 0.82 (0.40–0.965) 0.965 0.40 (21,24,25)
Asymptomatic infection w/o PEP (all groups) 0.50 0.65 0.40 (1,3,5,7,8,26)
Full recovery after acute (gp) 0.74 Residual (0.934) Residual (0.576) (79)
Full recovery after acute illness (hr) 0.28 Residual (0.739) Residual (0.076) (79)
Full recovery after acute illness (pw) 0.08 Residual (0.57) Residual (0.02) (79)
Probability of hospitalization and recovery given acute illness (gp) 0.04 0.01 0.05 (5,7,27)
Probability of hospitalization and recovery given acute illness (hr) 0.01 0.01 0.05 (5,7)
Probability of hospitalization and recovery given acute illness (pw) 0.01 0.01 0.02 (5,7)
Q fever fatigue syndrome (gp) 0.20 0.05 0.30 (1,10,16,2830)
Q fever fatigue syndrome (hr) 0.30 0.05 0.20 (1,10,16,2830)
Q fever fatigue syndrome (pw) 0.03 Residual (0.03) Residual (0.04) (1,10,16,17,2830)
Death from acute illness (gp) 0.01 0.001 0.024 (7,911)
Death from acute illness (hr and pw) 0.02 0.001 0.024 (7,911)
Chronic disease (gp) 0.01 0.005 0.05 (8,11,12,26,31)
Chronic disease (hr) 0.39 0.20 0.65 (13,14,31)
Chronic disease (pw) 0.86 0.39 0.90 (17)
Endocarditis (all groups) 0.65 0.60 0.90 (1,7,8)
Death from endocarditis (all groups) 0.10 0.05 0.60 (1,3,7,8,11,15,32)
Death from other chronic diseases (all groups) 0.30 0.05 0.60 (9)
Abortion or neonatal death 0.38 0.25 0.56 (8,14 ,17,21)
Premature birth/low birth weight baby 0.33 0.25 0.28 (8,14,17,21)
Healthy, unaffected baby 0.29 0.50 0.16 (8,14,17,21)

*PEP, postexposure prophylaxis; NA, not applicable; gp, general population; hr, high-risk; pw, pregnant women. See online Appendix Table 1 for a detailed explanation of how the primary input values were selected.

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