title: [Q fever outbreak in an urban area following a school-farm visit].
abstract: OBJECTIVE
  The aim of this study was to describe an outbreak of Q fever in a group of people (day care centre for mental-handicapped individuals) previously exposed to animals in a school-farm.
  
  
  METHODS
  A retrospective cohort study among the 25 mental-handicapped individuals and the 30 workers of the centre was performed. The information about symptoms and signs and antecedents of exposition was obtained by an epidemiological survey and a clinical-epidemiological case definition was established. Serum samples from 29 people (5 mental-handicapped individuals and 24 workers) were processed for serology (Indirect Immunofluorescence against Coxiella burnetii).
  
  
  RESULTS
  Twenty two cases of Q fever were detected. Ten were confirmed by serology (6 of them asymptomatic). More frequent symptoms were fever (100%), anorexia (81.3%), asthenia (68.8%) and non-productive cough (56.3%) among the 16 clinical cases. The risk of acute infection was 8.6 times higher in individuals of the centre that visited the school-farm (95% CI, 1.26-58.27).
  
  
  CONCLUSIONS
  The investigation of the epidemiological antecedents allowed to detect and confirm a Q fever outbreak, to identify the probable source of exposition and to orientate the clinical and serological diagnosis.
authors.affiliation: Servicio de Salud Pública del Area 4, Instituto de Salud Pública, Comunidad de Madrid, Madrid, España. rosa.delosrios@salud.madrid.org
authors.forename: Rosa
authors.initials: R
authors.lastname: de los Ríos-Martín
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Sanz-Moreno
authors.forename: Fernando
authors.initials: F
authors.lastname: Martín-Martínez
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Tébar-Betegón
authors.forename: Marta
authors.initials: M
authors.lastname: Cortés-García
authors.forename: Raquel
authors.initials: R
authors.lastname: Escudero-Nieto
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D015331:Cohort Studies; D016001:Confidence Intervals; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D011778:Q Fever / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D013030:Spain / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial