Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic
(2015) PLOS ONE — Vol. 10, n° 7, p. e0131848 (2015)
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- Authors
van Loenhout, Joris 
- Abstract
- Background: Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007–2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever. Methods: A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever. Results: Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6%) were included in the analysis. At any time during the four-year follow-up period, 58 (4.5%) patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ≥1:1,024 to as serologic criterion for chronic Q-fever). Fifty-two (89.7%) of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months. Conclusions: A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ≥1:512, as they showed the highest risk to progress to chronic Q-fever
- Affiliations
Department of Primary and Community Care Radboud University Medical Center
Citations
Wielders, C. C. H., van Loenhout, J., Morroy, G., Rietveld, A., Notermans, D. W., Wever, P. C., Renders, N. H. M., Leenders, A. C. A. P., van der Hoek, W., Schneeberger, P. M., & Samuel, J. E. (2015). Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic. PLOS ONE, 10(7), e0131848. https://doi.org/10.1371/journal.pone.0131848 (Original work published 2015)