title: Acute Q fever: an emerging and endemic disease in southern Taiwan.
abstract: Acute Q fever is a worldwide zoonosis caused by Coxiella burnetii infection. In Taiwan, cases of acute Q fever increased during 3 y of observation, especially at Kaohsiung County and City in southern Taiwan. From 15 April 2004 to 15 April 2007, a total of 67 cases of acute Q fever were identified at E-Da hospital located at Kaohsiung County. 19 (28.4%) patients had a history of travel in rural areas and only 1 had been outside southern Taiwan. 21 (31.3%) patients had a history of animal contact. 20 (30.8%) of the 65 examined patients had underlying chronic hepatitis B or hepatitis C virus infection. Fever (98.5%), chills (79.1%), headache (79.1%), relative bradycardia (44.8%), elevated aminotransferases (100%), and thrombocytopenia (74.6%) were common manifestations. 12 (19.0%) cases had abnormal findings on chest X-ray. Fatty liver (50.0%) and hepatomegaly and/or splenomegaly (41.9%) were found by abdominal image examinations. 42 (76.4%) of 55 cases had defervescence within 3 d after treatment, whereas 4 (7.3%) had spontaneous remission. Acute Q fever is an endemic infectious disease with hepatitis rather than pneumonia as the major presentation in southern Taiwan and the emergence of Q fever is due to increased alertness for the disease by physicians.
authors.affiliation: Sections of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaoshiung County, Taiwan, Republic of China.
authors.forename: Chung-Hsu
authors.initials: CH
authors.lastname: Lai
authors.forename: Chun-Kai
authors.initials: CK
authors.lastname: Huang
authors.forename: Chuen
authors.initials: C
authors.lastname: Chin
authors.forename: Hsing-Chun
authors.initials: HC
authors.lastname: Chung
authors.forename: Wu-Shiung
authors.initials: WS
authors.lastname: Huang
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Lin
authors.forename: Chuan-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Hsi-Hsun
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011778:Q Fever / Q000453:epidemiology* / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology