Estimated prevalence of chronic Q fever among Coxiella burnetii seropositive patients with an abdominal aortic/iliac aneurysm or aorto-iliac reconstruction after a large Dutch Q fever outbreak.

Abstract

OBJECTIVES:

The aim of this study was to estimate the seroprevalence of Q fever and prevalence of chronic Q fever in patients with abdominal aortic and/or iliac disease after the Q fever outbreak of 2007-2010 in the Netherlands.

METHODS:

In November 2009, an ongoing screening program for Q fever was initiated. Patients with abdominal aortic and/or iliac disease were screened for presence of IgM and IgG antibodies to phase I and II antigens of Coxiella burnetii using immunofluorescence assay and presence of C. burnetii DNA in sera and/or vascular wall tissue using polymerase chain reaction (PCR).

RESULTS:

A total of 770 patients with abdominal aortic and/or iliac disease were screened. Antibodies against C. burnetii were detected in 130 patients (16.9%), of which 40 (30.8%) patients showed a serological profile of chronic Q fever. Three patients presented with acute Q fever, one of which developed to chronic Q fever over time. The number of aneurysm-related acute complications in patients with chronic Q fever was significantly higher compared to patients negative for Q fever (p = 0.013); 9.0% (30/333) vs. 30.0% (6/20). Eight out of 46 patients with past resolved Q fever (8/46, 17.4%) presented with aneurysm-related acute complications (no significant difference).

CONCLUSION:

The prevalence of chronic Q fever in C. burnetii seropositive patients with abdominal aortic and/or iliac disease living in an epidemic area in the Netherlands is remarkably high (30.8%). Patients with an aneurysm and chronic Q fever present more often with an aneurysm-related acute complication compared to patients without evidence of Q fever infection.

• Authors: Julia C J P Hagenaars, Peter C Wever, André S van Petersen, Peter J Lestrade, Monique G L de Jager-Leclercq, Mirjam H A Hermans, Frans L Moll, Olivier H J Koning, Nicole H M Renders
• Journal: The Journal of infection (J Infect) Vol. 69 Issue 2 Pg. 154-60 (Aug 2014) ISSN: 1532-2742 [Electronic] England
• PMID: 24647145 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antibodies, Bacterial
• DNA, Bacterial
• Immunoglobulin G
• Immunoglobulin M

Topics

• Aged
• Antibodies, Bacterial (blood)
• Aortic Aneurysm (diagnosis, epidemiology, microbiology)
• Comorbidity
• Coxiella burnetii (isolation & purification)
• DNA, Bacterial (blood, isolation & purification)
• Disease Outbreaks
• Female
• Humans
• Iliac Aneurysm (complications, diagnosis, epidemiology, microbiology)
• Immunoglobulin G (blood)
• Immunoglobulin M (blood)
• Logistic Models
• Male
• Netherlands (epidemiology)
• Prevalence
• Q Fever (blood, diagnosis, epidemiology)
• Risk Factors
• Seroepidemiologic Studies