Naslov
Clinical and epidemiological features of hospitalized acute Q fever cases from Split-Dalmatia County (Croatia), 1985-2002

Autori
Lukšić, Boris ; Punda-Polić, Volga ; Ivić, Ivo ; Bradarić, Ivica ; Bradarić, Nikola

Izvornik
Medical Science Monitor (1234-1010) 12 (2006), 3; 126-131

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Coxiella burnetii; epidemiology; Q fever; clinical presentations

Sažetak
Aim. To identify specificities of the epidemiologic and clinical characteristics of acute Q fever patients, thus to contribute to the understanding of this zoonosis in three ecologically different areas in south Croatia. Methods. Acute Q fever patients hospitalized at Split University Hospital from January 1985 till December 2002 were analyzed. Acute Q fever cases were defined by febrility >38 °C, and clinical finding on the lungs and/or liver, verified by serologic testing with Coxiella burnetii phase II antigen. Complement fixation reaction was used in the diagnosis until 1990, and indirect immunofluorescence assay after 1990. Serologic diagnosis of acute Q fever was based on negative to positive seroconversion or at least fourfold antibody increase in paired serum samples, and on demonstration of IgM titer ł1:50 and IgG titer ł1:200 against Coxiella burnetii phase II antigen. Results. During the period of observation, 155 acute Q fever patients were hospitalized at Split University Hospital. No case of acute Q fever was recorded on the islands. The mean incidence of acute Q fever in the study region was 0.20/100, 000/year (95% confidence interval [CI]: 0-0.78) in the coastal area and 4.64/100, 000/year (95% CI: 0.44-8.85) in the hinterland, showing a male predominance (c2=60.0 ; p=0.0000) and mean male to female ratio of 4.17:1. All age groups (4-76 years) were involved, the highest rate of infection (78.06%) being recorded in the 20-49 age groups (mean incidence 3.31/100, 000/year). The annual incidence of acute Q fever was 0-19 cases per year, with a significantly higher incidence in the period after 1992 (c2=5.4 ; p=0.02) and highest monthly incidence in March. Six Q fever epidemics (5 familial and one among soldiers) were recorded. Clinically, acute Q fever most commonly presented with both pneumonia and hepatitis (60.0%), followed by pneumonia (25.8%), hepatitis (9.0%), and nonspecific febrile illness (5.2%). Conclusion. Coxiella burnetii, the causative agent of Q fever, is endemic in the hinterland rural areas of south Croatia with developed cattle breeding and especially sheep breeding. In this areas Q fever occurs sporadically and epidemically. Acute Q fever was not demonstrated on the islands of the region, whereas only sporadic cases were recorded in the littoral.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

POVEZANOST RADA