One-year follow-up of patients of the ongoing Dutch Q fever outbreak: clinical, serological and echocardiographic findings
In 2007, a large goat-farming-associated Q fever outbreak occurred in the Netherlands. Data on the clinical outcome of Dutch Q fever patients are lacking. The current advocated follow-up strategy includes serological follow-up to detect evolution to chronic disease and cardiac screening at baseline to identify and prophylactically treat Q fever patients in case of valvulopathy. However, serological follow-up using commercially available tests is complicated by the lack of validated cut-off values. Furthermore, cardiac screening in the setting of a large outbreak has not been implemented previously. Therefore, we report here the clinical outcome, serological follow-up and cardiac screening data of the Q fever patients of the current ongoing outbreak.
The implementation of a protocol including clinical and serological follow-up at baseline and 3, 6 and 12 months after acute Q fever and screening echocardiography at baseline.
Eighty-five patients with acute Q fever were identified (male 62%, female 38%). An aspecific, flu-like illness was the most common clinical presentation. Persistent symptoms after acute Q fever were reported by 59% of patients at 6 months and 30% at 12 months follow-up. We observed a typical serological response to Coxiella burnetii infection in both anti-phase I and anti-phase II IgG antibodies, with an increase in antibody titres up to 3 months and a subsequent decrease in the following 9 months. Screening echocardiography was available for 66 (78%) out of 85 Q fever patients. Cardiac valvulopathy was present in 39 (59%) patients. None of the 85 patients developed chronic Q fever.
Clinical, serological and echocardiographic data of the current ongoing Dutch Q fever outbreak cohort are presented. Screening echocardiography is no longer part of the standard work-up of Q fever patients in the Netherlands.
- One-year follow-up of patients of the ongoing Dutch Q fever outbreak: clinical, serological and echocardiographic findings
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Volume 38, Issue 6 , pp 471-477
- Cover Date
- Print ISSN
- Online ISSN
- Urban and Vogel
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- Q fever
- Coxiella burnetii
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- Author Affiliations
- 1. Department of Pulmonary Diseases, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6525 SZ, Nijmegen, The Netherlands
- 2. Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- 3. Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- 4. Department of Medical Microbiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands
- 5. Gemeentelijke Gezondheidsdienst “Hart voor Brabant” (Municipal Health Service “Hart voor Brabant”), ‘s-Hertogenbosch, The Netherlands
- 6. Huisartsenpraktijk Herpen (GP Practice Herpen), Herpen, The Netherlands
- 7. Bernhoven Hospital, Oss, The Netherlands