title: Comparison between emerging Q fever in French Guiana and endemic Q fever in Marseille, France.
abstract: Q fever is an emergent disease in French Guiana. We compared the incidence clinical and serologic profiles between patients from Cayenne, French Guiana and Marseille in metropolitan France during a four-year period. The annual incidence of diagnosed acute Q fever was significantly higher in Cayenne (17.5/100,000) than in Marseille (1.9/100,000) (P = 0.0004), but not the annual incidence of endocarditis (1.29 versus 0.34/100,000). Most patients had fever (97%) and pneumonia (83%) in Cayenne versus 81% and 8% in Marseille (P < 0.0001 and P < 0.0001, respectively) but transaminitis was more common in patients from Marseille (54% versus 32%; P < 0.0001). The proportion of patients with cardiovascular infections was significantly lower in Cayenne (7%) than in Marseille (17%) (P = 0.017), although they showed a stronger immune response with higher levels of phase I IgG (P = 0.024). The differing epidemiology, clinical, and serologic responses of patients from Cayenne and Marseille suggest a different source of infection and a different strain of Coxiella burnetii.
authors.affiliation: Aix Marseille Université, Marseille, France; Department of Infectious and Tropical Disease, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.
authors.forename: Sophie
authors.initials: S
authors.lastname: Edouard
authors.forename: Aba
authors.initials: A
authors.lastname: Mahamat
authors.forename: Magalie
authors.initials: M
authors.lastname: Demar
authors.forename: Philippe
authors.initials: P
authors.lastname: Abboud
authors.forename: Felix
authors.initials: F
authors.lastname: Djossou
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000382:microbiology; D021821:Communicable Diseases, Emerging; D016997:Coxiella burnetii; D004269:DNA, Bacterial / Q000302:isolation & purification; D019353:Endemic Diseases; D005260:Female; D005602:France / Q000453:epidemiology; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011778:Q Fever / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D007074:Immunoglobulin G