title: From Q Fever to Coxiella burnetii Infection: a Paradigm Change.
abstract: Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Eldin
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Cléa
authors.initials: C
authors.lastname: Mélenotte
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Oleg
authors.initials: O
authors.lastname: Mediannikov
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Ghigo
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Million
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Edouard
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Mege
authors.affiliation: Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France.
authors.forename: Max
authors.initials: M
authors.lastname: Maurin
authors.affiliation: URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France didier.raoult@gmail.com.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000818:Animals; D016997:Coxiella burnetii / Q000472:pathogenicity*; D016680:Genome, Bacterial; D006801:Humans; D011778:Q Fever / Q000175:diagnosis* / Q000453:epidemiology* / Q000662:veterinary; D014774:Virulence; D015047:Zoonoses / Q000453:epidemiology
keywords: Coxiella burnetii; Q fever; diagnosis; epidemiology; genomics; treatment