Journal Article

Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak

van der Hoek, Wim, Morroy, Gabriëlla, Albers, Jelle, Schneeberger, Peter M., Bleeker-Rovers, Chantal P., Coutinho, Roel A.

2015

Overview

From 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications. The most serious complication of Q-fever is chronic Q-fever. In 2014, we contacted all 2,161 adult inhabitants of the first village in the Netherlands affected by the Q-fever epidemic and offered to test for antibodies against Coxiella burnetii using immunofluorescence assay (IFA) to screen for chronic infections and assess whether large-scale population screening elsewhere is warranted. Of the 1,517 participants, 33.8% were IFA-positive. Six IFA-positive participants had an IgG phase I titer ≥1:512. Two of these six participants were previously diagnosed with chronic Q-fever. Chronic infection was diagnosed in one of the other four participants after clinical examination. Seven years after the initial outbreak, seroprevalence remains high, but the yield of screening the general population for chronic Q-fever is low. A policy of screening known high-risk groups for chronic Q-fever in outbreak areas directly following an outbreak might be more efficient than population screening. A cost-effectiveness analysis should also be performed before initiating a population screening program for chronic Q-fever.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Age / Aged / Analysis / Aneurysms / Antibodies / Antibodies, Bacterial - blood / Chronic Disease / Chronic infection / Communicable Disease Control / Communicable Diseases - epidemiology / Cost analysis / Cost-Benefit Analysis / Coxiella burnetii / Cross-Sectional Studies / Disease control / Disease Outbreaks / Endocarditis / Epidemics / Female / Fever / Fluorescent Antibody Technique / Health aspects / Health risk assessment / Health services / Humans / Immunofluorescence / Immunoglobulin G / Immunoglobulin G - blood / Infection / Infections / Infectious diseases / Inhabitants / Laboratories / Male / Mass Screening - economics / Mass Screening - methods / Medical screening / Middle Aged / Netherlands / Outbreaks / Phlebotomy / Population / Q fever / Q Fever - diagnosis / Q Fever - epidemiology / Questionnaires / Risk Factors / Risk groups / Screening / Seroepidemiologic Studies / Serology / Studies / Surveys and Questionnaires / Tomography / Zoonoses