engleski

Q-fever in Croatia

The first case of Q-fever was diagnosed in Croatia in 1948. Q-fever is endemic in our country, and outbreaks as well as sporadic cases have been recorded. The disease is seen primarily among adults, especially in persons with direct or indirect contact with infected sheep. Q fever appears seasonally with the peak of cases in the spring during the lambing. The incidence of Q fever has been increasing in the last few years in Croatia, with several hundred reported cases to the Epidemiology Service of the National Institute of Public Health. We retrospectively analysed clinical and epidemiological characteristics in Q fever in 25 patients hospitalized at the University Hospital for Infectious Diseases in Zagreb from January 1 to December 31, 2004. The diagnosis of Q fever was confirmed by serology for Coxiella burnetii, by an enzyme-linked immunosorbent assay (ELISA). The disease was registered from March to August. All cases were sporadic. The patients belonged to general population from Zagreb and its surrounding areas. Presumably, patients with Q fever were exposed to C. burnettii in their place of living in 13/25 (52, 0%) other parts of Croatia in 10/25 (40, 0%), while 2/25 (8, 0%) patients were in Bosnia and Herzegovina during the incubation period. there were more males (22/25 or 88, 0%) than females. Most of the patients were aged 21-30 years (12/25 or 48, 0%). Main symptoms of disease were fever, headache, and cough, and most significant laboratory findings were accelerated erythrocyte sedimentation rate and increased value of C-reactive protein. Chest X-ray revealed interstitial pulmonary infiltrates in the majority of patients, localized in a single pulmonary lobe (23/25 or 92, 0%). Pleural effusion was recorded in 2/25 (8, 0%) patients. The patients were treated with azithromycin, fluoroquinolone, and doxycycline. Doxycycline showed the best clinical efficacy. All patients were discharged from hospital as improved or cured without fatality.

Q fever; Clinical charactersitics; Epidemiology

nije evidentirano