The natural history of acute Q fever: a prospective Australian cohort.

The natural history of acute Q fever: a prospective Australian cohort.

QJM. 2016 Apr 1;

Authors: Hopper B, Cameron B, Li H, Graves S, Stenos J, Hickie I, Wakefield D, Vollmer-Conna U, Lloyd AR

Abstract
BACKGROUND: A detailed description of the natural history of acute Q fever, caused by infection withCoxiella burnetii,Aim:To significantly increase understanding of the illness.
DESIGN: Subjects with provisional acute Q fever (n=115) were recruited from primary care in rural Australia, and followed prospectively by interview and blood collection including for serological confirmation. A nested series of subjects with prolonged illness (cases), and those without (controls), were investigated in detail.
METHODS: Total phase I and phase II anti-C. burnetiiantibodies were detected by complement fixation test (CFT); and IgG, IgM and IgA phase I and phase II titres by immunofluorescence (IFA). Flow cytometric analysis was conducted to enumerate circulating T cells subsets, B cells, monocytes, and natural killer (NK) cells.
RESULTS: Serological testing confirmed acute Q fever in 73 subjects (63%). The acute illness featured fever, headache, sweats, fatigue, and anorexia; and varied widely in severity, causing an average of 8 days in bed and 15 days out of work or other role in the first month of illness. The illness course varied from two days to greater than a year. No cases of chronic, localised Q fever infection, such as endocarditis, were identified. Neither severe nor prolonged illness were associated with persistence ofC. burnetiiDNA, altered patterns ofC. burnetii-specific IgG, IgM or IgA antibody production, or altered leucocyte subsets.
CONCLUSIONS: The severity of acute Q fever alone predicted prolonged duration. Further studies are warranted to better understand the pathophysiology of prolonged illness after acute Q fever.

PMID: 27037328 [PubMed - as supplied by publisher]

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