title: Endemic Q Fever in New South Wales, Australia: A Case Series (2005-2013).
abstract: Q fever is endemic in Australia, and during the period 2005-2013 our laboratory diagnosed 379 cases in New South Wales. To evaluate clinical symptoms, epidemiology, mode of diagnosis, antibody profiles, and treatment, a subset of 160 (42%) Q fever cases were analyzed in detail following the return of a questionnaire by the patient's doctor and from their laboratory reports. Overall, 82% patients were male and predominantly middle aged. The majority of patients (89%) had animal contact among which 63% were with cattle, 11% with sheep, and 7% with kangaroos. Clinical symptoms were nonspecific: myalgia (94%), fever (91%), headache (80%), acute fatigue (64%), and arthralgia (55%). Most cases (93%) were acute, and serology (immunofluorescence) was the main diagnostic modality. Positive real-time polymerase chain reaction results were useful in the diagnosis of both acute and chronic Q fever, as was the isolation of Coxiella burnetii in cell culture. Doxycycline was the antibiotic most commonly used.
authors.affiliation: Australian Rickettsial Reference Laboratory, Newcastle Branch, New South Wales, Australia. Department of Microbiology, Pathology North-John Hunter Hospital, New South Wales, Australia. graves.rickettsia@gmail.com.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Graves
authors.affiliation: Australian Rickettsial Reference Laboratory, Newcastle Branch, New South Wales, Australia. Department of Microbiology, Pathology North-John Hunter Hospital, New South Wales, Australia.
authors.forename: Aminul
authors.initials: A
authors.lastname: Islam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D002417:Cattle / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016997:Coxiella burnetii / Q000302:isolation & purification; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007614:Macropodidae / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011778:Q Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012756:Sheep / Q000382:microbiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D004318:Doxycycline