Q fever in Plymouth, 1972-88. A review with particular reference to neurological manifestations.
Between 1972 and 1988 we have serologically confirmed 103 Coxiella burnetii infections: 46 were acute, 5 were chronic, 52 represented past infections. Details of 61 cases are presented. Of acute cases 80% had respiratory involvement; at least 63% had pneumonias. The incidence (22%) of neurological complications was of particular interest; 40% of these patients had prolonged sequelae. One acutely ill patient died of fulminating hepatitis. Patients with pre-existing pathology or immunosuppression were especially susceptible to C. burnetii. In the absence of acute sera, the complement fixation test alone provided inadequate differentiation between recent and past Q fever: phase II titres persisted at greater than or equal to 80 for more than 1 year after the acute infection in 15 cases; maximum duration of persistence was 14 years. Three patients acquired high phase I titres. Only 5% of cases had chronic Q fever, but in view of the diverse sequelae observed in this series, we suggest that long-term serological and clinical follow-up of all cases of Q fever is fully justified.
Department of Microbiology, Derriford Hospital, Plymouth.
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S
Reilly
J L
JL
Northwood
E O
EO
Caul
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D003168:Complement Fixation Tests; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology; D011778:Q Fever / Q000150:complications / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies