• The Journal of infection · Aug 2014

    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.

    • 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, and Nicole H M Renders.
    • Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. Electronic address: j.c.j.p.hagenaars@gmail.com.
    • J. Infect. 2014 Aug 1;69(2):154-60.

    ObjectivesThe 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.MethodsIn 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).ResultsA 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).ConclusionThe 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.Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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