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Clinical and epidemiological features of hospitalized acute Q fever cases from Split-Dalmatia County (Croatia), 1985-2002 (CROSBI ID 106177)

Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija

Lukšić, Boris ; Punda-Polić, Volga ; Ivić, Ivo ; Bradarić, Ivica ; Bradarić, Nikola Clinical and epidemiological features of hospitalized acute Q fever cases from Split-Dalmatia County (Croatia), 1985-2002 // Medical science monitor, 12 (2006), 3; 126-131-x

Podaci o odgovornosti

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

engleski

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

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.

Coxiella burnetii; epidemiology; Q fever; clinical presentations

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Podaci o izdanju

12 (3)

2006.

126-131-x

objavljeno

1234-1010

Povezanost rada

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

Indeksiranost