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Volume 18, Number 4—April 2012
Research

Identification of Risk Factors for Chronic Q Fever, the Netherlands

Linda M. KampschreurComments to Author , Sandra Dekker, Julia C.J.P. Hagenaars, Peter J. Lestrade, Nicole H.M. Renders, Monique G.L. de Jager-Leclercq, Mirjam H.A. Hermans, Cornelis A.R. Groot, Rolf H.H. Groenwold, Andy I.M. Hoepelman, Peter C. Wever, and Jan Jelrik Oosterheert
Author affiliations: University Medical Centre Utrecht, Utrecht, the Netherlands (L.M. Kampschreur, R.H.H. Groenwold, A.I.M Hoepelman, J.J. Oosterheert); VU University, Amsterdam, the Netherlands (S. Dekker); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (J.C.J.P. Hagenaars, P.J. Lestrade, N.H.M. Renders, M.H.A. Hermans, P.C. Wever); Bernhoven Hospital, Oss/Veghel, the Netherlands (M.G.L. de Jager-Leclercq, C.A.R. Groot)

Main Article

Table 1

Classification of chronic Q fever according to Dutch Q Fever Consensus Group guidelines*

Classification Definition
Proven Any of the following:
Positive PCR for Coxiella burnetii in serum, plasma, or tissue in the absence of acute Q fever
IFA phase I titer ≥1,024 with definite endocarditis according to the revised Duke criteria (21)
Indication of vascular infection on PET/CT, CT, MRI, or ultrasound testing
Probable IFA phase I IgG titer >1,024 and any of the following clinical manifestations:
Valvulopathy not meeting the criteria of endocardial involvement of the major modified Duke criteria (22)
Aneurysm, vascular prosthesis or prosthetic valve without signs of infection on PET/CT, CT, MRI, or ultrasound testing
Signs of possible chronic Q fever infection of noncardiac or vascular origin on PET/CT, CT, or ultrasound testing
Pregnancy
Clinical symptoms of chronic infection (i.e., fever, night sweats, weight loss, hepatosplenomegaly)
Histopathologic proven granulomatous inflammation
Immune disorder
Possible IFA phase I IgG titer >1,024 without clinical manifestations as described above

*Described in (20). IFA, immunofluorescence assay; PET, positron emission tomography; CT, computed tomography; MRI, magnetic resonance imaging.

Main Article

References
  1. Raoult  D, Marrie  T, Mege  J. Natural history and pathophysiology of Q fever. Lancet Infect Dis. 2005;5:219–26. DOIPubMedGoogle Scholar
  2. Parker  NR, Barralet  JH, Bell  AM. Q fever. Lancet. 2006;367:679–88. DOIPubMedGoogle Scholar
  3. Angelakis  E, Raoult  D. Q fever. Vet Microbiol. 2010;140:297–309. DOIPubMedGoogle Scholar
  4. Maurin  M, Raoult  D. Q fever. Clin Microbiol Rev. 1999;12:518–53.PubMedGoogle Scholar
  5. Tissot-Dupont  H, Raoult  D. Q fever. [ix.]. Infect Dis Clin North Am. 2008;22:505–14. DOIPubMedGoogle Scholar
  6. Fenollar  F, Fournier  PE, Carrieri  MP, Habib  G, Messana  T, Raoult  D. Risks factors and prevention of Q fever endocarditis. Clin Infect Dis. 2001;33:312–6. DOIPubMedGoogle Scholar
  7. Frankel  D, Richet  H, Renvoise  A, Raoult  D. Q fever in France, 1985–2009. Emerg Infect Dis. 2011;17:350–6.PubMedGoogle Scholar
  8. Raoult  D, Tissot-Dupont  H, Foucault  C, Gouvernet  J, Fournier  PE, Bernit  E, Q fever 1985–1998. Clinical and epidemiologic features of 1,383 infections. Medicine (Baltimore). 2000;79:109–23. DOIPubMedGoogle Scholar
  9. Botelho-Nevers  E, Fournier  PE, Richet  H, Fenollar  F, Lepidi  H, Foucault  C, Coxiella burnetii infection of aortic aneurysms or vascular grafts: report of 30 new cases and evaluation of outcome. Eur J Clin Microbiol Infect Dis. 2007;26:635–40. DOIPubMedGoogle Scholar
  10. Delsing  CE, Kullberg  BJ, Bleeker-Rovers  CP. Q fever in the Netherlands from 2007 to 2010. Neth J Med. 2010;68:382–7.PubMedGoogle Scholar
  11. Brouqui  P, Dupont  HT, Drancourt  M, Berland  Y, Etienne  J, Leport  C, Chronic Q fever. Ninety-two cases from France, including 27 cases without endocarditis. Arch Intern Med. 1993;153:642–8. DOIPubMedGoogle Scholar
  12. Tissot-Dupont  H, Vaillant  V, Rey  S, Raoult  D. Role of sex, age, previous valve lesion, and pregnancy in the clinical expression and outcome of Q fever after a large outbreak. Clin Infect Dis. 2007;44:232–7. DOIPubMedGoogle Scholar
  13. van der Hoek  W, Dijkstra  F, Schimmer  B, Schneeberger  PM, Vellema  P, Wijkmans  C, Q fever in the Netherlands: an update on the epidemiology and control measures. Euro Surveill 2010;15:pii=19520 [cited 2011 May 20]. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19520
  14. Hogema  BM, Slot  E, Molier  M, Schneeberger  PM, Hermans  MH, van Hannen  EJ, Coxiella burnetii infection among blood donors during the 2009 Q-fever outbreak in the Netherlands. Transfusion. Epub 2011 Jul 14.PubMedGoogle Scholar
  15. Fenollar  F, Fournier  PE, Raoult  D. Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection. J Clin Microbiol. 2004;42:4919–24. DOIPubMedGoogle Scholar
  16. Musso  D, Raoult  D. Coxiella burnetii blood cultures from acute and chronic Q-fever patients. J Clin Microbiol. 1995;33:3129–32.PubMedGoogle Scholar
  17. Healy  B, van Woerden  H, Raoult  D, Graves  S, Pitman  J, Lloyd  G, Chronic Q fever: different serological results in three countries—results of a follow-up study 6 years after a point source outbreak. Clin Infect Dis. 2011;52:1013–9. DOIPubMedGoogle Scholar
  18. Dupont  HT, Thirion  X, Raoult  D. Q fever serology: cutoff determination for microimmunofluorescence. Clin Diagn Lab Immunol. 1994;1:189–96.PubMedGoogle Scholar
  19. Rolain  JM, Lecam  C, Raoult  D. Simplified serological diagnosis of endocarditis due to Coxiella burnetii and Bartonella. Clin Diagn Lab Immunol. 2003;10:1147–8.PubMedGoogle Scholar
  20. Wegdam-Blans  MCA, Kampschreur  LM, Nabuurs-Franssen  MH, Renders  NHM, Delsing  CE, Bijlmer  HA. Dutch consensus chronic Q fever [in Dutch]. Tijdschr Infect. 2011;6:71.
  21. Li  JS, Sexton  DJ, Mick  N, Nettles  R, Fowler  VG Jr, Ryan  T, Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:633–8. DOIPubMedGoogle Scholar
  22. Landais  C, Fenollar  F, Thuny  F, Raoult  D. From acute Q fever to endocarditis: serological follow-up strategy. Clin Infect Dis. 2007;44:1337–40. DOIPubMedGoogle Scholar
  23. Wegdam-Blans  MC, Nabuurs-Franssen  MN, Horrevorts  AM, Peeters  MF, Schneeberger  PM, Bijlmer  HA. Laboratory diagnosis of acute Q fever [in Dutch]. Ned Tijdschr Geneeskd. 2010;154:A2388.PubMedGoogle Scholar
  24. van der Hoek  W, Versteeg  B, Meekelenkamp  JC, Renders  NH, Leenders  AC, Weers-Pothoff  I, Follow-up of 686 patients with acute Q fever and detection of chronic infection. Clin Infect Dis. 2011;52:1431–6. DOIPubMedGoogle Scholar
  25. Jager  MM, Weers-Pothoff  G, Hermans  MH, Meekelenkamp  JC, Schellekens  JJ, Renders  NH, Evaluation of a diagnostic algorithm for acute Q fever in an outbreak setting. Clin Vaccine Immunol. 2011;18:963–8. DOIPubMedGoogle Scholar
  26. Limonard  GJ, Nabuurs-Franssen  MH, Weers-Pothoff  G, Wijkmans  C, Besselink  R, Horrevorts  AM, One-year follow-up of patients of the ongoing Dutch Q fever outbreak: clinical, serological and echocardiographic findings. Infection. 2010;38:471–7. DOIPubMedGoogle Scholar
  27. Limonard  GJ, Nabuurs-Franssen  MH, Dekhuijzen  PN, Groot  CA. Prevention of Q fever endocarditis. Lancet Infect Dis. 2011;11:82–3. DOIPubMedGoogle Scholar
  28. Kidney Disease Outcome Quality Initiative clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. National Kidney Foundation. 2002 [cited 2011 June 13]. http://www.kidney.org/professionals/kdoqi/guidelines_ckd/p4_class_g1.htm
  29. Betjes  MG, Langerak  AW, van der Spek  A, de Wit  EA, Litjens  NH. Premature aging of circulating T cells in patients with end-stage renal disease. Kidney Int. Epub 2011 Apr 27.PubMedGoogle Scholar
  30. El Nahas  M. Cardio-Kidney-Damage: a unifying concept. Kidney Int. 2010;78:14–8. DOIPubMedGoogle Scholar
  31. Weiskopf  D, Weinberger  B, Grubeck-Loebenstein  B. The aging of the immune system. Transpl Int. 2009;22:1041–50. DOIPubMedGoogle Scholar
  32. Lloyd-Jones  DM, Leip  EP, Larson  MG, D’Agostino  RB, Beiser  A, Wilson  PW, Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age. Circulation. 2006;113:791–8. DOIPubMedGoogle Scholar
  33. Fenollar  F, Thuny  F, Xeridat  B, Lepidi  H, Raoult  D. Endocarditis after acute Q fever in patients with previously undiagnosed valvulopathies. Clin Infect Dis. 2006;42:818–21. DOIPubMedGoogle Scholar
  34. Million  M, Thuny  F, Richet  H, Raoult  D. Long-term outcome of Q fever endocarditis: a 26-year personal survey. Lancet Infect Dis. 2010;10:527–35. DOIPubMedGoogle Scholar
  35. Munster  JM, Leenders  AC, van der Hoek  W, Schneeberger  PM, Rietveld  A, Riphagen-Dalhuisen  J, Cost-effectiveness of a screening strategy for Q fever among pregnant women in risk areas: a clustered randomized controlled trial. BMC Womens Health. 2010;10:32. DOIPubMedGoogle Scholar
  36. Huijsmans  CJ, Schellekens  JJ, Wever  PC, Toman  R, Savelkoul  PH, Janse  I, Single-nucleotide-polymorphism genotyping of Coxiella burnetii during a Q fever outbreak in the Netherlands. Appl Environ Microbiol. 2011;77:2051–7. DOIPubMedGoogle Scholar

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Page updated: March 14, 2012
Page reviewed: March 14, 2012
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