engleski

Q-fever in Croatia

Serum samples (180 paired and 90 single specimens) from 270 patients with suspected Q-fever were tested at the Dept. of Virology, Croatian National Institute of Public Health from January to December 2003. The patients were from nearly all parts of Croatia ; most of them were from Dalmatia (Split, Sinj, Šibenik, Zadar, Obrovac, Benkovac, Vrlika), followed by those from Slavonia (Osijek, Vinkovci, Virovitica, Vukovar, Našice, Požega, Slavonski Brod), northwest Croatia (Zagreb, Koprivnica, Slatina, Novigrad Podravski), central Croatia (Sisak, Vojnić, Gospić, Otočac, Ogulin) and Istria (Pula, Pazin, Vrsar). According to clinical symptoms, the patients were divided into three groups: group I – patients with clinical picture of atypical pneumonia (N=164) ; group II – patients with acute febrile disease (N=30) ; group III – asymptomatic patients referred for testing because they stayed in the endemic area (N=76). The disease was confirmed serologically by detection of specific antibodies to phase II Coxiella burnetti (C. burnetti) using the complement-fixation test (micromethod). A fourfold or greater increase in antibody titre in paired sera as well as titre  1:32 in single specimen were considered a positive finding. Etiologic diagnosis of Q-fever was confirmed in 98 (36%) patients. Depending on clinical picture, the incidence of infections caused by C. burnetti was 52% (85/164) in patients with atypical pneumonia, 33% (10/30) in patients with acute febrile disease and 4% (3/76) in asymptomatic patients. The mean patient age was 32, 7 years (range 2-72 years). Except of six children (five aged 2-8 years and one aged 14 years), all of the patients were adults. Males became affected more often (82%) then females (18% ; ratio 5, 4:1). The largest number of cases was registered in Splitsko-Dalmatinska and Zadarsko-Kninska Counties (Sinj, Zadar, Obrovac, Benkovac). A majority of sporadic cases were recorded from February to May, with the epidemic reported in Dalmatia in February and March on the Zagreb-Split highway construction site.

Coxiella burnetti; Q-fever

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