title: Clinical presentation of acute Q fever in Spain: seasonal and geographical differences.
abstract: OBJECTIVE
  The aims of this study were to improve our understanding of the clinical forms of presentation of acute Q fever in Spain and to determine any possible relationships with geographical and seasonal factors.
  
  
  METHODS
  This was a retrospective study of 183 cases of acute Q fever from three Spanish regions, Catalonia, Canary Islands, and La Rioja.
  
  
  RESULTS
  The main clinical form of presentation was hepatitis (49.2%), followed by isolate febrile syndrome (31.7%) and pneumonia (19.1%). The proportion of cases presenting as pneumonia was significantly higher in La Rioja (40.7%) than in Catalonia (18.3%) or the Canary Islands (12.9%) (p=0.001). In Catalonia and the Canary Islands, most cases (52.1% and 57.6%, respectively) were diagnosed between March and June, whereas in La Rioja, most cases (51.8%) occurred between November and February. Overall, the proportion of cases presenting as pneumonia was significantly higher in the period from November to February (32.6%) than in the periods March-June (16.0%) and July-October (13.0%) (p=0.01).
  
  
  CONCLUSIONS
  Our results suggest the existence of seasonal differences in the presentation of acute Q fever in Spain, with a higher proportion of pneumonic forms in the colder months. Furthermore, we confirmed the existence of geographical differences, with a higher proportion of pneumonic forms in the region of La Rioja, in the north of the country.
authors: Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227 Terrassa, Spain. Electronic address: 12088eea@comb.cat.
authors: Elena
authors: E
authors: Espejo
authors: Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
authors: Aída
authors: A
authors: Gil-Díaz
authors: Hospital San Pedro-CIBIR, Logroño, Spain.
authors: José Antonio
authors: JA
authors: Oteo
authors: Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
authors: Renato
authors: R
authors: Castillo-Rueda
authors: Hospital San Pedro-CIBIR, Logroño, Spain.
authors: Lara
authors: L
authors: García-Alvarez
authors: Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
authors: Sergio
authors: S
authors: Santana-Báez
authors: Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227 Terrassa, Spain.
authors: Feliu
authors: F
authors: Bella
mesh_terms: D000328:Adult; D005260:Female; D006505:Hepatitis / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012621:Seasons; D013030:Spain
keywords: Coxiella burnetii; Geographical differences; Seasonal variation; Zoonosis