[Q fever in Extremadura: an emerging infection].
OBJECTIVE
Q fever (Coxiella burnetii infection) is an underdiagnosed zoonosis in our area, Extremadura, a rural region in the Southwest of Spain. The characteristics of Q fever and the changes in this infection seen over the last decade in our hospital are described.


METHODS
A total of 124 cases of Q fever diagnosed in the Infectious Diseases Unit of a tertiary hospital Hospital Universitario Infanta Cristina de Badajoz) during the years 1992-2005 were analyzed. The epidemiological, clinical, serological and therapeutic data of the patients, and the factors related with hospital admittance are described.


RESULTS
Mean age was 41 +/- 16 years, most patients were males (4:1 ratio), 61% lived in rural areas and 47% mentioned some kind of contact with farm animals. The clinical presentation included non-focalized fever (53%), hepatitis (43%), pneumonia (11%), and endocarditis (6%). The factors related with the need for hospital admission were diagnosis after 1999 (OR: 12.2; 95% CI: 3.2-47.6), pneumonia (OR: 4.1; 95% CI: 1.1-15.9), and hepatitis (OR: 2.7; 95% CI: 1.2-6.3). During the second half of the study period there were more cases of Q fever, the interval of time to diagnosis was shorter (P = 0.042), and there was a significant increase in hospitalizations (55% versus 9%; P < 0.0001).


CONCLUSIONS
In Extremadura, Q fever is an emerging infection that predominates in males who are in contact with animals for work purposes. Non-focalized fever is the most frequent form of clinical presentation; pneumonia is rare. Hospitalization for Q fever infection has increased over the last years.
Muñoz-Sanz
Agustín
A
Hospital Universitario Infanta Cristina, Servicio Extremeño de Salud, Universidad de Extremadura, Badajoz, España. a.munoz-sanz@telefonica.net
Vera
Araceli
A
Rodríguez Vidigal
Francisco Félix
FF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000453:epidemiology*; D000822:Animal Husbandry; D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000382:microbiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000635:transmission; D004197:Disease Reservoirs / Q000382:microbiology / Q000662:veterinary; D005260:Female; D015511:Goat Diseases / Q000382:microbiology; D006041:Goats; D006261:Headache / Q000453:epidemiology / Q000382:microbiology; D006331:Heart Diseases / Q000453:epidemiology / Q000382:microbiology; D006505:Hepatitis / Q000453:epidemiology / Q000382:microbiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000382:microbiology; D011778:Q Fever / Q000453:epidemiology* / Q000635:transmission; D012189:Retrospective Studies; D012424:Rural Population; D012621:Seasons; D012756:Sheep; D012757:Sheep Diseases / Q000382:microbiology; D013030:Spain / Q000453:epidemiology; D015047:Zoonoses